1. ENVIRONMENTAL ASSESSMENT FORM (E.A. FORM)
    2. INSTRUCTIONS
    3. Instructions
      1. MODULE S1: PROJECT SUMMARY
      2. MODULE S2: RESOURCE IDENTIFICATION AND CHARACTERIZATION
      3. MODULE S3: IDENTIFICATION AND DESCRIPTION OF POTENTIAL PROJECT IMPACTS
      4. MODULE S4: MITIGATION PLAN
      5. CERTIFICATION AND FEE
    4. APPENDIX I
    5. APPENDIX II
    6. REGIONAL OFFICES
    7. APPENDIX II
    8. REGIONAL OFFICES continued
    9. APPENDIX III
    10. U.S. ARMY CORPS OF ENGINEERS DISTRICT OFFICES
    11. Appendix IV
    12. Subfacility Codes and Descriptions
      1. Subfacility
      2. Authorized Activities/Structures
      3. Location of
      4. Lat/Long PointCode Name
    13. Appendix VSubfacility Details
      1. Subfacility
      2. Authorized Activities/Structures
      3. Code Name
      4. Subfacility Authorized Activities/Structures
      5. Code Name
      6. Subfacility
      7. Authorized Activities/Structures
      8. Code Name
      9. Subfacility
      10. Authorized Activities/Structures
      11. Code Name
      12. Field Name and Description
      13. Subfacility
      14. Authorized Activities/Structures
      15. Code Name
      16. Field Name and Description
      17. Field Name and Description
      18. Subfacility
      19. Authorized Activities/Structures
      20. Code Name
      21. Field Name and Description
      22. Subfacility
      23. Authorized Activities/Structures
      24. Code Name
      25. Field Name and Description
      26. Field Name and Description
      27. Subfacility
      28. Authorized Activities/Structures
      29. Code Name
      30. Subfacility
      31. Authorized Activities/Structures
      32. Code Name
      33. Field Name and Description
      34. Field Name and Description
      35. Subfacility
      36. Authorized Activities/Structures
      37. Code Name
      38. Field Name and Description
      39. Subfacility
      40. Authorized Activities/Structures
      41. Code Name
      42. Field Name and Description
      43. Subfacility
      44. Authorized Activities/Structures
      45. Code Name
      46. Field Name and Description

3150-PM-BWEW0017
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WATERWAYS ENGINEERING AND WETLANDS
ENVIRONMENTAL ASSESSMENT FORM (E.A. FORM)
INSTRUCTIONS
For more information,
please visit DEP's website at
www.dep.pa.gov

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Instructions
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Instructions
If you are seeking a Water Obstruction and Encroachment Permit to "build in" reservoirs, lakes, ponds,
swamps, wetlands, marshes, bogs, floodways, waterways, or open waters in Pennsylvania, an Environmental
Assessment must be approved by the DEP as part of the permit review process.
The Environmental
Assessment (E.A.) is a necessary part of a complete Chapter 105 Dam Safety and/or Water
Obstruction and Encroachment (105 WO&E) Permit application.
If you are completing the E.A. as part
of a permit application, several maps, plans and other information requested herein may already be included
as part of the overall application package and therefore do not have to be duplicated. In these instances,
please reference where in the application package the information is provided on the E.A. form and any
additional responses provided. However, these documents must be included with the Environmental
Assessment if a permit is not required.
IN THE FOLLOWING CIRCUMSTANCES, A CHAPTER 105 PERMIT IS NOT NECESSARY; HOWEVER,
AN APPROVED ENVIRONMENTAL ASSESSMENT IS REQUIRED:
§105.12(a)(11)
-
Waiver No. 11 removal of abandoned dams, water obstructions and
encroachments.
§105.12(a)(16)
-
Waiver No. 16 restoration activities associated with an approved DEP
Restoration Plan.
§105.15(b)
-
For structures or activities where water quality certification is required
under Section 401 of the Clean Water Act (33 U.S. CA. §1341). These
activities include but are not limited to Federal Nationwide Permits (NWP)
and other regulated activities under Section 404 of the Clean Water Act
and Section 10 of the River and Harbors Act of 1899.
§105.15(a)(2) and (3)
-
Non-jurisdictional dams that are located in wetlands or an exceptional
value water as defined in Chapter 93.
The fee required for a project authorized under these permit waivers (when a Chapter 105 permit is not
necessary) shall be consistent with 25 PA Code §105.13 (relating to regulated activities – information and
fees). See §105.13(c)(2)(iv) for additional information.
The Environmental Assessment is not necessary when registering the use of a General Permit. However,
when applying for a 105 WO&E permit that includes project impacts that are otherwise eligible for use of a
General Permit or qualify under waiver of permit requirements under 105.12(a), the structures, activities,
resources and potential impacts shall be included in the E.A. Form responses.
For further information regarding E.A.’s, please contact the Waterways and Wetland Program in the
appropriate DEP Regional Offices listed on Appendix II.
Except as provided for below related to small project applications, applicants are reminded that the
Chapter 105 E.A. Form will not be considered complete unless the form is filled out in its entirety, all questions
answered, responses and supporting information provided in the application.
THE E.A. INFORMATION
SHOULD BE PRESENTED IN THE PERMIT APPLICATION USING THE OUTLINE FORMAT AND
ORGANIZATIONAL IDENTIFIERS (MODULES, SECTIONS AND SUBSECTIONS) PROVIDED IN THE E.A.
FORM AND E.A. INSTRUCTIONS.

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Small Project Application Submissions:
The following applies to small project applications unless, if upon
review, the Department determines that more information is required to determine whether a small project will
have an insignificant impact on safety and protection of life, health, property or the environment, the
Department may require the applicant to submit additional information and processing fees required under
this chapter.
A project that directly or indirectly affects wetlands is not eligible as a small project application, a
standard permit application including completion of the entire E.A. Form must be submitted to the
Department.
APPLICATIONS FOR SMALL PROJECTS SHALL INCLUDE THE FOLLOWING INFORMATION FROM
THE E.A. FORM:
Module S1
- All information requested; and
Module S2*
- A, B, C; and
Module S3
*- A, B, C; and
Module S4*
- None.
*As previously described, portions of the following Modules and Sections: S2.D;
S3.D, E, F, G, H; S4.A, B, C and D may apply if deemed necessary for review of
the application on a case by case basis.
The information presented in the permit application should follow and be presented utilizing the
outline format and organizational identifiers (module, section and subsections) provided in the E.A.
Form and E.A. Instructions.
DEP has developed a standardized review process and processing times for
all permits or other authorizations that it issues or grants. Pursuant to its Permit Review Process and Permit
Decision Guarantee Policy (021-2100-001), DEP guarantees to provide permit decisions within the published
time frames, provided applicants submit complete, technically adequate applications/registrations that
address all applicable regulatory and statutory requirements, in the first submission.
Note: Failure to utilize the Module, Section and subsection identifiers may result in delays during the
Completeness Review
.

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MODULE S1: PROJECT SUMMARY
This module is intended to present an overall summary of the project scope, certain key information
requirements and when applicable, a comprehensive view of the overall project and related projects. These
regulatory requirements and Department policies including, but not limited to, the following are applicable to
this Module: Comprehensive Environmental Assessment of Proposed Project Impacts for Chapter 105 Water
Obstruction and Encroachment Permit Applications (CEA Policy: Document No.
310-2137-006
);
105.13(e)(1)(iii); 105.13(e)(1)(x); 105.13(f)(4); 105.18a(a)(6); and 105.18a(b)(6).
Project Description: Provide an overall project description that includes, but is not limited to, the items
outlined below:
1. If the "overall" project a) requires more than one Ch. 105 permit in more than one county OR b)
will be completed in more than one phase, address items S1.A.1.i – iv, below; otherwise, proceed
to S1.B below.
i.
Provide the project "Comprehensive Environmental Assessment" as described in the CEA
Policy for large multi-county or multi-phase projects.
i.
Describe the nature and extent of the "overall" project and anticipated timeline(s) of
construction.
ii. Provide a list of all other additional Chapter 105 application(s) or registration(s) associated with
the "overall" project that have been submitted to the Department or Chapter 105 delegated
Conservation District.
iii. Provide a summary table of the "overall" project's known impacts and those anticipated to
occur in the future based on (ii) and (iii) above.
Additional Information: Provide the information requested in the items below:
1. A detailed discussion of the project purpose and need. Applicants should reflect back to the
discussion of project purpose and need as part of the alternatives analysis provided in
Module S3.F
below.
Any supporting information that pertains to the project purpose or
establishing the need for the project that facilitates the alternatives analysis should be included in
this section. If an applicant anticipates the project may have an adverse effect to Exceptional
Value (EV) wetlands or a significant adverse effect to Other wetlands, as described under
§105.18a; the applicant should anticipate the need to address §105.18a(c) regarding the
demonstration that the project is necessary to abate a substantial threat to the public health or
safety and that the requirements of subsection §105.18a(b)(2) - (7) are met.
2. A statement of water dependency describing the need to be within or in close proximity to water
or requires access or proximity to or siting within a wetland to fulfill the basic purposes of the
project.
3. Provide a summary table of the amount and types of resources present on the project site from
Module S2.B
associated with the application
4. Provide a summary table of the proposed project permanent and temporary direct and indirect
impacts from
Module S3.A
associated with the application

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MODULE S2: RESOURCE IDENTIFICATION AND CHARACTERIZATION
This module is intended to organize information related to the identification of the resources present on the
project site and to characterize those resources that may be affected by the proposed project. These
regulatory requirements and Department policies including, but not limited to, the following are applicable to
this Module: 105.13(e)(1)(i)(A); 105.13(e)(1)(ii); 105.13(e)(1)(iii); 105.13(e)(1)(x); 105.13(e)(2); 105.13(e)(3);
105.13(f)(4)(i); 105.13(f)(4)(iii); 105.15; Policy for Pennsylvania Natural Diversity Inventory (PNDI)
Coordination During Permit Review and Evaluation (PNDI Policy: Document No.
021-0200-001
)
Standard Resource Identification Information:
1. Provide the following information for the organization(s) and person(s) performing aquatic
resource identification, determination, delineation and related field work: Organization name(s),
mailing addresses, first and last name of person(s), email address, portions of work completed
and qualifications.
2. If wetlands are not present at the site, attach a copy of the wetland determination report. Include
all field data sheets, photos, sample locations, etc. that support this determination. If this
information details any physical information or features not shown in the “site plan”, please attach
additional plans which illustrate these features.
Or
If wetlands are present at the site, attach a copy of the wetland delineation report. Include all field
data sheets, photos, sample locations, etc. and denote the size (in acres) of the wetland within
project area of interest and estimated size of any areas extending outside project area. Include a
brief narrative of the delineation process used and copies of any supporting materials used such
as hydric soil maps, wetland maps, aerial imagery, etc. If this information details any physical
information or features not shown in the “site plan”, please attach additional plans which illustrate
these features.
3. If watercourses are present at the site, attach a copy of any report related to determining if a
feature is a watercourse and the hydrologic flow status (e.g. intermittent or perennial). Include all
field data sheets, photos, sample locations, etc. and denote the channel, floodway and floodplain
dimensions of the watercourse in cross-section view. Include a brief narrative of the determination
process used and copies of any supporting materials or cross reference to other application
sections. If this information details any physical features not shown in the “site plan”, please attach
additional plans which illustrate them.
4. If not already included in the permit application package, attach a location map or plan
(e.g. 1:2400 scale or greater) that must show the location of the project, all natural features
including the names and boundaries of regulated waters of this Commonwealth, natural areas,
wildlife sanctuaries, natural landmarks, political boundaries, locations of public water supplies and
other geographical or physical features including cultural, archeological and historical landmarks
within 1 mile of the site. The features identified in
S2.A.5
and all water resources identified in
S2.B
below shall be included.

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5. Is the site located within or adjacent to any of the following; or within 100 feet of items vii or viii?
Be sure to mark either “YES” or “NO” in each column on the E.A. Form.
i.
National, state or local park, forest or recreation area?
ii.
National natural landmark?
iii.
National wildlife refuge, or Federal, state, local or private wildlife
or plant sanctuaries?
iv. State Game Lands?
v.
Areas identified as prime farmland?
vi. Source for a public water supply?
vii. A National Wild or Scenic River or the Commonwealth’s Scenic
Rivers System?
viii. Designated Federal wilderness area?
The following resources are suggested to assist in answering the above questions:
U.S.G.S. quadrangle maps contain valuable information, such as wild, natural, or wilderness
areas, and National wildlife refuges and sanctuaries.
A current PA Recreation Guide Map locating state parks, state forests and state game lands
is available from DCNR by calling 1-888-PA-PARKS or from state-owned recreation areas in
Pennsylvania.
Prime farm land information is available from the County Conservation District Office.
Contact the Bureau of Safe Drinking Water in the appropriate DEP Regional Office for
information on public water supplies. A list of DEP Regional Offices can be found in
Appendix II of this section.
For information on waterways designated as “Wild” or “Scenic” under the Pennsylvania Scenic
Rivers Act and National Wild or Scenic River corridors:
Pennsylvania Scenic Rivers
www.dcnr.state.pa.us/brc/conservation/rivers/scenicrivers/index.htm
If your project area appears to be in a Pennsylvania scenic river corridor, contact the
DCNR, Bureau of Recreation and Conservation, Partnerships Division, Scenic Rivers
Program, 400 Market Street, 5
th
Floor, Harrisburg, PA 17101, phone 717-772-3319 for
confirmation.
National Wild or Scenic Rivers
https://www.rivers.gov/pennsylvania.php
. If your project
appears to be in a National Wild or Scenic River, contact one of the following:
U.S. Forest Service
Allegheny National Forest
4 Farm Colony Drive
Warren, PA 16365
U.S. National Park Service
NPS Wild & Scenic Rivers
200 Chestnut Street
Philadelphia, PA 19106

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Identify all aquatic resources present that may be affected on the project site: Provide the following
information when applicable:
1. Project specific unique resource identifier (e.g. W### for wetlands, R### for watercourses and
L### for ponds, reservoirs, etc.)
2. Resource type: watercourse-channel (riverine), watercourse-floodway, watercourse-floodplain
only, wetland or other body of water (lacustrine).
For a desk analysis of the water resources which exist on the project site, refer to the United
States Geological Service quadrangle maps for the project area. These maps are available
for reference at the local delegated Conservation District office. Refer to the telephone
directory under the County for the Conservation District. Also, these maps may be purchased
from one of the retail establishments listed on the internet at
www.usgs.gov
and may be
accessed electronically at
http://www.pasda.psu.edu
.
Floodway and Floodplain information is available from the Department of Community and
Economic Development, Governor’s Center for Local Government Services, Keystone
Building, 400 North Street, Harrisburg, PA 17120, 1-888-223-6837. Federal Emergency
Management Agency (FEMA) maps are often available for reference at county and municipal
planning offices and may be accessed electronically at
https://msc.fema.gov/portal
or
http://www.pasda.psu.edu
.
The Soil Survey for your county along with the list of hydric soils for the county are helpful
office references regarding wetlands.
These resources are available at the website
https://www.nrcs.usda.gov/wps/portal/nrcs/main/soils/survey/
, or the Web Soil Survey
website
http://websoilsurvey.nrcs.usda.gov
, or from the Conservation District.
Refer to
telephone directory under the County for the Conservation District.
When identifying and delineating wetlands on site, the 1987 Corps Wetland Delineation
Manual, the appropriate Regional Supplements to the Corps of Engineers Wetland
Delineation Manual for use in Pennsylvania and the current National Wetland Plan List for
Pennsylvania Regions are essential. They may be obtained by contacting:
The National Wetland Plant List
U.S. Army Corps of Engineers 2016.
National Wetland Plant List, version 3.3
http://wetland-plants.usace.army.mil/nwpl_static/index.html
U.S. Army Corps of Engineers
Engineer Research and Development Center
Cold Regions Research and Engineering Laboratory, Hanover,
NH
The 1987 Corps Wetland Delineation Manual
The US Army Corps of Engineers
http://www.usace.army.mil/Missions/Civil-Works/Regulatory-Program-and-Permits/reg_supp/
3. Size of the existing resource: channel length and average width in feet; size of the watercourse
floodway, floodplain, wetland or other body of water in acres (to the nearest 0.01 acre).

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4. List any fishery designations; information on stocked waters and wild trout streams may be
obtained from the Pennsylvania Fish and Boat Commission, contact the Bureau of Fisheries,
Division of Fisheries Management 450 Robinson Lane, Bellefonte, PA 16823-9620, phone
814-359-5110
5. List the Title 25 Pa. Code Chapter 93 Existing or Designated use(s) of the watercourse(s)
(e.g. CWF, WWF, etc.) or the Title 25 Pa. Code Chapter 105 wetland classification (e.g. O - Other
or EV - Exceptional Value). Provide the analysis of whether any wetlands present are EV (related
to §105.17), when applicable.
List the Special Protection water uses (e.g. High Quality - HQ or EV) of the watercourse(s) as
provided for in Title 25 Pa. Code Chapter 93 whether Existing or Designated use(s). Additional
information on HQ and EV waters and 25 Pa. Code Chapter 93 respectively can be found on the
internet at:
http://www.dep.pa.gov/Business/Water/PointNonPointMgmt/WaterQuality/Pages/ExistingUse.as
px
; and
http://www.pacode.com/secure/data/025/chapter93/chap93toc.html
25 Pa. Code Chapter 93 also provides an important linkage to Exceptional Value Wetlands
which are determined in 25 Pa. Code Chapter 105.17 found at:
http://www.pacode.com/secure/data/025/chapter105/s105.17.html
Habitat for Federal threatened and endangered (T&E) plant and animal species or State T&E species
or species of special concern:
Coordination with the Pennsylvania Natural Heritage Program (PNHP) regarding the presence of
Federal threatened and endangered (T&E) species and State T&E or species of special concern on
the project site is a 25 Pa Code Chapter 105 regulatory requirement. Early coordination (prior to
submission) with the appropriate jurisdictional agencies using the PA Conservation Explorer,
previously known as the Pennsylvania Natural Diversity Inventory (PNDI) Environmental Review Tool
(PNDI ER Tool), is the most effective means of timely permit decisions. The PA Conservation Explorer
can be accessed at the www.naturalheritage.state.pa.us/ website. First time users must register at
the website before conducting the review. Upon completion of the review, a PNDI Receipt, valid for a
period of two years from the date the search was conducted, is automatically available for printing.
To provide proof of coordination with PNHP and PNDI, applicants must submit a PNDI Receipt as
part of the permit application/registration.
PNDI reviews can still be obtained free-of-charge for users without access to a computer using the
standard process of requesting a project review directly from each jurisdictional agency—PA
Department of Conservation and Natural Resources (DCNR), PA Game Commission (PGC), PA Fish
and Boat Commission (PFBC) and the U.S. Fish and Wildlife Service (US FWS) instead of generating
a PNDI Receipt instantly through the PA Conservation Explorer. The standard PNDI review process
user is responsible for securing PNDI Receipts from each jurisdictional agency—DCNR, PGC, PFBC
and the U.S. FWS.
PNDI
Receipts
from
each
jurisdictional
agency
shall
be
included
with
the
application/registration package.
The PNDI review is not complete or satisfied unless PNDI Receipts are included from all four
jurisdictional agencies listed above.
Applicants are encouraged to use the PA Conservation Explorer use of this tool is the most
effective means of a timely permit decision.

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Instructions
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1. Provide the completed Search form or Copy of PNDI search receipt(s) as part of the E.A.
responses.
2. Did the PNDI search or agency coordination identify any potential conflicts?
If answered YES, provide responses to the following:
i.
Answer the following questions related to the PNDI Policy:
a. Is the applicant utilizing a sequential review of the PNDI coordination?
b. Is the applicant utilizing a concurrent review of the PNDI coordination?
ii. Provide unique resource identifier used in
S2.B
above when potential conflict is associated
with an identified resource.
iii. Provide the following in addition to the completed Final Search form or Copy of Final PNDI
search receipt(s) as part of the E.A. responses:
a. Provide evidence as part of E.A. responses that potential conflicts have been resolved,
include any written recommendations provided by an appropriate resource agency(s) or
reference location in application if not.
b. List and cross reference any design changes or avoidance measures incorporated into
design plans, construction notes, erosion and sediment control plans, narrative project
description, etc.
c. Any avoidance measures agreed to by the applicant that requires their signature on the
PNDI Final Form,
shall be signed by the applicant and not an agent on their behalf
.
iv. Discuss and cross reference (e.g., agency correspondence, section/page number in the
Mitigation Plan) any avoidance and minimization efforts taken to resolve the potential
conflict(s).
Characterize all aquatic resources present that may be affected by the project: Where applicable,
provide information regarding the resources that are proposed to be directly or indirectly affected by
the project. If more than one resource is assessed, provide a table of the summary results including
items i-iii. Include the following information and any other available relevant information:
1.
Riverine Resources
- Provide the following information for each riverine resource listed in
S2.B
above, when more than one resource is assessed, provide a table of the summary results
including items i-iv:
i.
Unique resource identifier used in
S2.B
above.
ii. Provide Slope Category and Watershed Size using the tables provided below. Additional
information can be found in the PA Aquatic Communities Classification manual at:
http://www.naturalheritage.state.pa.us/aquaticsIntro.aspx
.
Gradient Class (GC)
Slope
Number
Description
1
Low Gradient
≤0.5%
2
Moderate Gradient
>0.50
≤2.0%
3
High Gradient
>2.0%

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Watershed Size (WS)
Drainage Area
Number
Description
1
Headwater
>0
≤2 mi
2
2
Small Stream
>2
≤10 mi
2
3
Mid-reach Stream
>10
≤100 mi
2
4
Large Stream/River
>100 mi
2
iii. Summary of the results from the PA Riverine Condition Level 2 Rapid Assessment Protocol
Document Number
310-2137-003
. Copies of the assessment area mapping, data sheets,
notes, photos and supporting information must be provided.
iv. Discuss the riverine resource type(s) and condition(s) as they relate to the inherent functions
including, but not limited to, those associated with hydrologic, biogeochemical and habitat
attributes. Include any recreational uses when applicable.
v. Describe the adjoining upstream and downstream riparian property (See
S3.D.4
to assist in
description purpose).
2.
Wetland Resources
- Provide the following information for each wetland resource listed in
S2.B
above, when more than one resource is assessed, provide a table of the summary results
including items i-v:
i.
Unique resource identifier used in
S2.B
above.
ii. Hydrogeomorphic (HGM) classification of wetlands; classification key available at:
PA_HGM_Key_1.0
.
iii. Cowardin vegetation class(s) (e.g. Palustrine Emergent - PEM, Palustrine Scrub Shrub – PSS,
Palustrine Forested - PFO, etc.)
iv. Palustrine Community Classification; classification key available at:
PA_PCC_Key_1.0
and
additional information on community classification and factsheets available at:
http://www.naturalheritage.state.pa.us/Communities.aspx
.
v. Summary of the results from the PA Wetland Condition Level 2 Rapid Assessment Protocol
Document Number
310-2137-002
. Copies of the assessment area mapping, data sheets,
worksheets, stressor checklist, notes, photos and supporting information must be provided.
vi. Discuss the wetland HGM type(s) and condition(s) as they relate to the inherent functions
including, but not limited to, those associated with hydrologic, biogeochemical and habitat
attributes include any recreational uses when applicable.
3.
Lacustrine Resources
- Provide the following information for each lacustrine resource listed in
S2.B
above, when more than one resource is assessed, provide a table of the summary results
including items i-ii:
i.
Unique resource identifier used in
S2.B
above.
ii. Summary of the results from the PA Lacustrine Condition Level 2 Rapid Assessment Protocol
Document Number
310-2137-004
. Copies of the assessment area mapping, data sheets,
notes, photos and supporting information must be provided.
iii. Discuss the resource type(s) and condition(s) as they relate to the inherent functions including,
but not limited to, those associated with habitat attributes. Include any recreational uses when
applicable.
4. Other Environmental Factors, Special Studies, Macro-invertebrate surveys, Mussel Surveys,
HGM Functional Assessment, Habitat Evaluation Models, etc. or Substitute Methods. – The
applicant should consult the Department early in the application development process if large
impacts to resources or impacts to Special Protection waters are anticipated (e.g. §105.13(e)(3))
to assist in determining if and/or which other environmental factors, special studies, surveys, etc.
are necessary as part of the E.A.

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The Department may approve the use of substitute methods used in place of
S2. D.1, 2
or
3
above
as an alternative or substitute assessment methodology for assessing resource conditions
(separate from and not contained in the applicable technical guidance) if that methodology is
determined by the Department to adequately identify and assess resource conditions for the
purposes of meeting regulatory requirements under Chapter 105. Complete and legally defensible
supporting documentation (rationale, calculations, etc.) regarding the use of a substitute
assessment methodology as it relates to the project application must be included with the
application. Additional application processing time may be necessary when using an alternative
methodology. For other special studies or surveys, etc. or substitute methods determined
necessary by the Department, provide at a minimum the following information for each study or
assessment performed:
i.
Unique resource identifier used in
S2.B
above.
ii. Purpose of the study or assessment.
iii. Summary of the results from the study or assessment. Copies of assessment area mapping,
data sheets, notes, photos and supporting information must be provided.
iv. Description of the factors, study or title of methodology used, discuss any deviations or
modifications to the methodology, etc.
v. Discussion of the results or findings as they related to the purpose of the study or assessment.
MODULE S3: IDENTIFICATION AND DESCRIPTION OF POTENTIAL PROJECT IMPACTS
This module is intended to organize and present information concerning the potential impacts or effects of
the proposed project in the application. Impacts related to the "overall" project that are proposed under
related but separate application(s) should be addressed as part of the CEA Policy response under
S1.A.1
and included as part of each permit application. These regulatory requirements and Department policies are
applicable to this Module, including, but not limited to the following: 105.13(e)(1)(ii); 105.13(e)(1)(iii);
105.13(e)(1)(viii); 105.13(e)(1)(x); 105.13(e)(3); 105.15; 105.18a(a)(3); 105.18a(a)(6); 105.18a(b)(3);
105.18a(b)(6); Ch. 105 Subchapters B, C, D, E, F, G, H, I and J; CEA Policy; and Water Quality
Antidegradation Implementation Guidance Policy (Antideg. Policy: Document No.
391-0300-002
).
Provide a summary table(s) of the proposed impacts for each affected resource category (e.g. riverine,
wetlands and lacustrine resources). The following information is provided to assist in categorizing
impacts:
Permanent Impacts
are those areas affected by a water obstruction or encroachment that consist of
both direct and indirect impacts that result from the placement or construction of a water obstruction or
encroachment and include areas necessary for the operation and maintenance of the water obstruction
or encroachment located in, along or across, or projecting into a watercourse, floodway or body of water.
Temporary Impacts
are those areas affected during the construction of a water obstruction or
encroachment that consists of both direct and indirect impacts located in, along or across, or projecting
into a watercourse, floodway or body of water that are restored upon completion of construction. This
does not include areas that will be maintained as a result of the operation and maintenance of the water
obstruction or encroachment located in, along or across, or projecting into a watercourse, floodway or
body of water (these are considered permanent impacts).
Direct Impacts
consist of filling, draining or conversion of a resource to another type such as a wetland
to an open body of water. Examples include placement of fill in a wetland, placement of a box culvert in
a stream, placement of fill in the floodplain and/or building a dam where the impoundment area will flood
resources (stream, floodplain or wetlands) with a sufficient depth as to change the existing aquatic
resource to another aquatic resource type. This would include changes such as converting a riverine
system to a lacustrine system, changing a palustrine wetland to a lacustrine system, etc.

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Indirect Impacts
consist of altering the chemical, physical or biological components of an aquatic
resource to the extent that changes to the functions of the resource results. However, indirect impacts
do not result in a loss of resource acreage. Changes include such things as conversion of a forested
wetland system to a non-forested state through chemical, mechanical or hydrologic manipulation that
results in a maintained state of vegetation; altered hydrologic conditions (increases or decreases) such
as stormwater discharges or water withdrawals that alter the chemical, physical or biological functions of
the resource, areas upstream and downstream of a culvert or bridge that require periodic excavation to
ensure waterway openings (e.g. bedload deposition removal), etc.
1. Provide summary of the total proposed permanent direct impacts.
2. Provide summary of the total proposed temporary direct impacts.
3. Provide summary of the total proposed permanent indirect impacts.
4. Provide summary of the total proposed temporary indirect impacts.
Standard Information Responses
1. From
S2.A.5
: If any of these resources were checked “YES”, discuss any potential impacts to
those resources in detail.
IMPORTANT NOTE: If either item vii or viii from S2 A.5 was answered YES, the project
is not eligible as a "Small Project Application" type. Complete all applicable sections
of the EA form for the standard application type unless an item was otherwise waived
by the Department in writing (see previous Note on waiving of information
requirements).
Subfacility Details Table(s): Provide a table(s) of all proposed water obstruction(s), encroachment
activities, and dams (e.g. subfacility codes) including any required details.
1. Unique project Subfacility identifier (e.g. A1, SC1, C1, B1, etc.)
2. List the applicable standard subfacility code and description (i.e. CULV, BRDG, WTIM, etc.) see
Appendix IV
for list of codes and descriptions.
3. List the riverine, wetland, and/or lacustrine unique resource identifier from
S2.B
above (more than
one may be listed) which the proposed subfacility affects.
4. Provide latitude and longitude coordinates for the subfacility see
Appendix IV
for the
recommended collection of coordinate data related to the subfacility type.
Note: The General
Information Form: Facility Information Section should be used to record the information related to
the collection method and accuracy of the locational data.
5. Provide the municipality and county in which each subfacility is located.
6. List the total permanent direct impacts for each subfacility.
7. List the total temporary direct impacts for the each subfacility.
8. List the total permanent indirect impacts for each subfacility
9. List the total temporary indirect impacts for each subfacility

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10. Provide key details for each subfacility see
Appendix V
for specific information related to
subfacility details by subfacility type.
Resource Function Effects: Provide a description of how the proposed subfacility(s), individually
and/or in combination, directly and/or indirectly impact the identified resource(s) and effects to the
resource functions previously discussed in Module S2. Discuss any other environmental impacts not
previously provided elsewhere.
1. Unique project Subfacility identifier
2. Discuss the types of impacts associated with the subfacility and the effect they have on the
resource functions as described in Module S2. When the same type of subfacility is proposed
(e.g. stream crossing utilizing a culvert and floodway fill), the description may include a general
description of the effects that the subfacility type has on the resource(s) with noted exceptions
related to specific locations made. The discussion should consider the following:
i.
Hydrologic- water quantity, streamflow, and sources, groundwater basal flows, drainage
patterns, flushing characteristics, flow currents, natural recharge or source areas, storm and
floodwater storage and control.
ii. Biogeochemical- changes in hydrodynamics, food chain production, maintenance of water
quality, Does the project degrade the water quality? Does it have an impact on water quality
to the extent that the watershed’s designated water use is impaired? (Refer to
S2.B.4
., above,
regarding designated water use as indicated in Chapter 93.)
iii. Habitat- general habitat provision (e.g. nesting, spawning, rearing, escape cover, feeding,
migration resting); environmental study areas (e.g. sanctuaries or refuges) and T&E species
or species of special concern (as identified in
S2.D
). Does the project impact fisheries? Will
the activity impair the ability of these watercourses to continue to provide habitat for aquatic
species? Special attention should be given to wild and stocked trout streams. Does the
project demonstratively reduce or degrade habitat for terrestrial, aquatic and/or avian
species? Is the degradation significant in a local or regional context? Will the degradation
influence biodiversity?
iv. Recreation- interference with the ordinary and customary use of the resource; including but
not limited to such uses as hunting, fishing, wildlife observation, swimming, boating, etc.
Recreational boating may also need to be considered, regardless of the official designation,
where there is a documented on-going use of the watercourse for boating, canoeing or other
types of recreation.
3. Discuss the effect of the subfacility on the overall regime and ecology of the watercourse or other
body of water, water quality, stream flow, fish and wildlife, aquatic habitat, instream and
downstream uses and other significant environmental factors.
4. Discuss any effects or changes on the property or riparian rights of owners upstream,
downstream, or adjacent to the project, resulting from the subfacility. Riparian rights are those
rights which are derived from the ownership of real property underlying or bordering streams and
rivers. The holder of riparian rights has no property right in the water itself but only a nonexclusive
right to the water. No right to divert or consume a specific quantity of water is obtained. An
individual’s riparian right depends upon the equal rights of other riparian holders (upstream and
downstream).
Historically, riparian rights have focused upon use and may be extended to the aesthetics of the
watercourse for personal satisfaction or enjoyment. Riparian rights must be considered in cases
where an increase or diminution of flow would result from the proposed activity and in cases where
the direction of flow would be altered.

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Antidegradation Analysis: The applicant must demonstrate consistency with State antidegradation
requirements. Project application information provided below in S3.E, F, G, and H may be cross-
referenced.
1. Provide sufficient information such as a comparison of resources, potential impacts, other relative
environmental factors, etc. to demonstrate that the project is consistent with the State
antidegradation requirements including those contained in 25 Pa. Code Chapter 93, Sections
93.4a through Section 93.4c; 25 Pa. Code Chapter 102, Sections 102.2, 102.4(b)(6), and
102.8(h); 25 Pa. Code Chapter 105, Sections 105.16(c), 105.18a(a)(6) - related to EV wetlands,
105.18a(b)(6) - related to Other wetlands, and 25 Pa. Code Chapter 95, when applicable. The
Applicant may summarize and use the antidegradation information from the Chapter 102 permit
application submitted for the project and summarize and use the information from this Chapter
105 permit application, which addresses the requirements of Chapter 105, Sections 105.16(c),
105.18a(a)(6) and 105.18a(b)(6).
Alternatives Analysis: The scope and extent of this analysis should be commensurate with the size
and scope of the proposed project impacts in the application. Information provided in S3.H, below,
related to avoidance and minimization efforts, may be cross-referenced in the responses.
1. Provide a description which demonstrates the unavailability of any practicable alternatives which
would avoid or minimize the adverse impacts of the dam, water obstruction(s) and/or
encroachment(s) proposed in the application that is not part of the responses submitted as part
of the CEA Policy that addresses the “overall” project under
S1.A.1.
An alternative is considered
practicable if it is available and capable of being carried out after taking into consideration
construction cost, existing technology and logistics. This description should include, but not be
limited to, consideration of the following:
i.
Alternative locations, including areas not presently owned by the applicant which could be
reasonably obtained, utilized, expanded or managed to fulfill the basic purpose of the project.
ii. Alternative routes or alignments
iii. Alternative designs, including reduction in scope, configuration or density.
2. For the preferred alternative, provide a description of onsite avoidance efforts with supporting
details.
3. For the preferred alternative, provide a description of onsite minimization efforts with supporting
details.
Potential Secondary Impact Evaluation: The potential secondary impact assessment is intended to
identify potential permit issues and project impacts for the entire parcel of land.
1. Identify and describe the direct and indirect environmental impacts on other adjacent land and
water resources associated with the construction, modification and/or operation of the dam,
reservoir, water obstruction, or encroachments around the project and areas adjacent thereto.
Consideration should also be given to project impacts on adjacent water resources. For example:
Will the project adversely impact those resources indirectly (i.e. loss of hydrology, wildlife
corridors, habitat, etc.)?
2. Identify and describe all other dams, water obstructions or encroachments, in addition to those
included in this application, and their potential future impacts necessary to fulfill the project
purpose. Dams, water obstructions and encroachments should be designed in consideration of
future land use to assure proper adequacy for future development. The Department may require
additional data relating to planning, subdivision and zoning.

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The cumulative impact of this project and other potential or existing projects on wetland
resources: Identify and evaluate the potential environmental impacts of this project, other potential or
existing projects like it, and the resulting impacts from numerous piece-meal changes to the
wetland resource.
1. Discuss the potential for cumulative wetland impacts and the process used to identify other
impacts as described in CEA Policy.
2. Identify and evaluate the potential cumulative impacts of this project and other potential or existing
projects like it, and the impacts that may result through numerous piecemeal changes to
the wetland resource.
i.
Cumulatively, do these piecemeal changes result in the impairment of the Commonwealth’s
exceptional value wetland resources.
ii. Cumulatively, do these piecemeal changes result in a major impairment of this
Commonwealth’s wetland resources.
MODULE S4: MITIGATION PLAN
This module is intended to organize and present information concerning actions undertaken in accordance
with the definition of Mitigation in Title 25 Pa. Code Chapter 105- 105.1, 105.16, 105.18a(a)(3), 105.18a(b)(7),
105.20a, and 105.21 as related to the potential impacts or effects of the proposed project in this application.
Note: Impacts related to the “overall” project that are proposed under related but separate application(s)
should be addressed as part of the CEA Policy response under
S1.A.1
.
The following regulatory
requirements and Department policies are applicable to this Module: 105.1; 105.13(e)(1)(ix); 105.16;
105.18a(a)(3); 105.18a(a)(7); 105.18a(b)(2); 105.18a(b)(3); 105.18a(b)(7); 105.20a; 105.21; Department’s
Design Criteria – Wetlands Replacement/Monitoring Policy (Wetland Design Criteria Policy: Document No.
363-0300-001
).
Provide a detailed response for individual proposed impact area(s) and the project as a whole for the
following:
1. Identify and describe any measures taken that resulted in avoiding resource impacts.
2. Identify and describe any measures taken that resulted in minimizing unavoidable resource
impacts.
Provide a detailed response for individual proposed impact area(s) and for the whole project that
address the following:
1. Identify and describe any repair, rehabilitation, or restorative actions taken to rectify an impacted
resource.
i.
Provide specific details and plans outlining how impacted resources will be repaired.
ii. Provide specific details and plans outlining how impacted resources will be rehabilitated.
iii. Provide specific details and plans outlining how impacted resources will be restored.
2. Identify and discuss any proposed preservation and maintenance operations that will be taken to
reduce or eliminate an impact during the life of the project.

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Identify and describe any actions undertaken related to the following compensatory mitigation items:
1. Does the applicant propose to utilize an approved mitigation bank to provide all or a portion of the
compensation? If YES, address items listed under
S4.C1.i.;
otherwise proceed to
S4.C.2
.
Note:
If the applicant proposes to utilize both mitigation bank credits and conduct permittee
responsible mitigation, all items in S4.C must be addressed.
i.
Provide a credit reservation/commitment letter from a mitigation banker approved to operate
within Pennsylvania. The letter shall be from the credit provider, addressed to the applicant,
and, at a minimum, include the following:
a. Legal name of the credit provider (aka banker);
b. Water Obstruction and Encroachment Compensation Operation Permit number;
c. Contact information for the credit provider;
d. Statement by credit provider attesting to credit availability or reservation (i.e. a credit may
not be simultaneously represented in credit availability letters to multiple applicants);
e. Specify the credit type(s) and amounts by resource type(s); and
f. Specify any time limitations (e.g. expiration date) placed on the credit availability or
reservation commitment.
2. Describe the proposed plans to compensate for the impacted wetland, riverine, and/or lacustrine
resources with a discussion of how the affected functions identified in Module S3 will be offset by
the compensation proposal.
3. Describe the proposed plans to compensate for the impacted resources including, but not limited
to, the following:
i.
Provide detailed design plans consistent with the proposed compensation. For wetlands,
specific reference is made to the Department’s Wetland Design Criteria Policy.
ii. For projects, which impact wetlands, provide a narrative explaining how the proposed plan:
a. Replaces the wetlands at a minimum area ratio of 1:1; (2:1 for after the fact permit
applications).
b. Replaces the wetland functions and values that are physically and biologically the same
as those that are lost at a minimum area ratio of 1:1; (2:1 for after the fact permit
applications).
iii. Performance standards shall be based on attributes related to the resource structure,
functions, ecological condition, or other such suitable methods and/or criteria to determine if
the site is achieving the proposed objectives. These standards may be incorporated into the
special conditions of the permit.
Monitoring Plans: When applicable, provide a plan to monitor the identified actions proposed in
S4.B
and/or
S4.C
compensatory mitigation area. The application should at a minimum reference the
erosion and sediment control plan final stabilization, however, in many instances additional steps
should be taken to ensure aquatic resources recover from the disturbances beyond just mere
stabilization including soil segregation, resource appropriate plantings, etc.
Actions taken under
S4.B
related to wetlands disturbances can utilize the existing USACE monitoring
template:
http://www.nab.usace.army.mil/Portals/63/docs/Regulatory/Permits/PASPGP-
5_Wetland_Monitoring_Report_for_Temporary_Impacts.pdf?ver=2016-07-07-122841-323
.

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Applicants
should
utilize
the
Department’s
Design
Criteria:
http://www.elibrary.dep.state.pa.us/dsweb/Get/Document-48803/363-0300-001.pdf
and
the
USACE’s RGL 08-03
http://www.usace.army.mil/Portals/2/docs/civilworks/RGLS/rgl08_03.pdf
to
develop monitoring plans for compensatory mitigation proposals. Those plans should include, but
are not limited to, the following:
1. Performance Standards - At a minimum, include the information regarding the
performancestandards established previously under
S4.C.3
. Performance Standards shall be
based on resource related functional, conditional, or other suitable assessment methods and/or
criteria that can be measured to demonstrate progress towards success.
2. Recommended Monitoring Duration and Timeframes - At a minimum, include the following
information:
i.
Expected beginning month and date of overall monitoring period, which usually consists of
five (5) full-growing seasons.
ii. Expected overall duration and schedule of monitoring events. Typically, monitoring events
should occur twice (2) a year for first two growing season and once annually during the
growing season for the final three years for a total of seven (7) site visits during a typical five-
year monitoring period.
iii. Monitoring reports should generally be submitted by December 1 of the year the monitoring
even took place. Alternative schedules may be proposed or provided as a condition of the
permit.
3. Monitoring Reports- At a minimum, reports should include or address the following items:
i.
Project overview:
a. Permit Id and current monitoring event
b. Responsible party conducting monitoring and dates of inspection or data collection
c. Brief description of the purpose of the project, resources involved, acreages, techniques,
etc.
d. Written directions to site location(s), latitude and longitude coordinates, location map, etc.
e. Date compensation actions were completed
f. Summary of performance standard achievement
g. Dates and description of any corrective actions since last report
ii. Requirements:
a. List of monitoring requirements
b. Performance standards in permit special conditions and/or approved compensation plan
c. Evaluation of whether site is achieving performance standards or is trending towards
achievement (use of table(s) for comparison purposes is recommended)
iii. Data Summarization:
a. Provide data to substantiate progress towards achieving performance standards and
conclusions reached
b. Color photographs. Including date taken, photo id, and direction of photograph

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iv. Maps and Plans:
a. General location map including nearby resource features
b. Photographic reference points
c. Sampling locations, transects, cross sections, etc.
d. Legends, clearly depicted site boundaries, habitat units, unique features, etc.
v. Conclusions:
a. General statement describing the conditions of the compensation project;
b. If performance standards are not being met, provide a brief explanation of
non-performance and specific recommendations for corrective or remedial actions
including a timetable for implementation
Note: Corrective or Remedial actions require prior approval unless actions are explicitly
pre-approved in advance as part of a submitted Adaptive Management Plan
4. Remedial Action/Adaptive Management Plan (RAMP) - When development of an RAMP is
necessary, address the flowing elements:
i.
Identify need for action and include description of how the problem was determined. Identify
probably causes with supporting data and observations.
ii. Identify the responsible party producing the RAMP.
iii. The Department must approve the RAMP prior to implementation
iv. Identify and describe how the implementation of the RAMP will occur including, but not limited
to, implementation dates, actions, inspections, etc.
v. Identify and describe specific elements addressing the monitoring of RAMP progress.
vi. Implementation
IMPORTANT NOTE: All or portions of this Module may apply to “Small Project” type
applications under case specific circumstances and should be discussed during any
pre-application meetings or prior to application submittal.
CERTIFICATION AND FEE
The completed E.A. Form will not be accepted unless the form is signed and dated.
The fee required for a project authorized under certain permit waivers (when the Chapter 105 permit
requirement is waived) shall be consistent with 25 PA Code §105.13 (relating to regulated activities –
information and fees). See §105.13(c)(2)(iv) for additional information. To determine the application fee,
please complete the
Chapter 105 Fee(s) Calculation Worksheet (3150-PM-BWEW0553)
. Please provide
the completed worksheet and a check for the applicable fee(s) made payable to the “Commonwealth of
Pennsylvania Clean Water Fund.”

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APPENDIX I
Please consult the appropriate Regional Office before applying any of the studies listed below.
HGM
Hydrogeomorphic Functional Assessment
Assessment:
Hydrogeomorphic (HGM) functional
assessment models for Pennsylvania
wetlands.
Document:
Penn State Coop. Wetl. Ctr. Rep. No. 98-6,
University Park. 50pp.
Source:
Wardrop, D. H., R. P. Brooks, L. Bishel-
Machung, and C. A. Cole. 1998.
Additional Information:
Until further notice contact the PA DEP
Bureau of Waterways Engineering and
Wetlands, Division of Wetlands,
Encroachment and Training
(717) 787-3411
IFIM
Instream Flow Incremental Methodology
Assessment:
IFIM assesses stream habitat. Plans
(methodologies) of study, logic, and skills for
decision-making are detailed in this technique.
Document:
Instream Flow Methodology
PB80181100 (order number)
Source:
National Technical Information Service (NTIS)
Springfield, VA 22151 1-800-553-6847
Additional Information:
National Conservation Training Center
U.S. Fish & Wildlife Service
Aquatic Resources Training
(304) 876-7445
HEP
Habitat Evaluation Procedure
Assessment:
HEP assesses environmental impacts and
establishes guidelines for resource
management. It utilizes a Habitat Suitability
Index (HSI) which is a system of mathematical
models employed to compute values for
selected species from field measurements of
habitat variables. Developed in 1980 by the
United States Fish and Wildlife Service.
Document:
Habitat Evaluation Procedure
PB81189896 (order number)
Source:
National Technical Information Service (NTIS)
Springfield, VA 22161
1-800-553-6847
Additional Information:
National Conservation Training Center
U.S. Fish and Wildlife Service
Aquatic Resources Training
(304) 876-7445
PAMHEP
Pennsylvania Modified Habitat
Evaluation Procedure
Assessment:
PAMHEP is the Habitat Evaluation Procedure
modified for specific use in Pennsylvania. It is
utilized by the Fish and Game Commissions and
other agencies in the Commonwealth.
Document:
PAMHEP Manual
Source:
The text is out of stock; 300 original copies were
published.
Cost:
Not in print
Contact:
United States Fish and Wildlife Service
Pennsylvania Field Office
110 Radnor Rd; Suite 101
State College, PA 16801
(814) 234-4090

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APPENDIX II
REGIONAL OFFICES
Environmental Assessment Forms associated with oil and gas activities -
The Environment Assessment Form and other associated documents must be sent to the appropriate DEP Bureau of
Oil and Gas Management, Surfaces Permitting Section, Regional Office listed below.
Bureau of District Oil and Gas Operations
County Responsibility
Northwest Regional Office
Northwest District
230 Chestnut Street
Butler, Clarion, Crawford, Elk, Erie, Forest, Jefferson,
Meadville, PA 16335
Lawrence, McKean, Mercer, Venango, and Warren
(814) 332-6860
Southwest Regional Office
Southwest District
400 Waterfront Drive
Allegheny, Armstrong, Beaver, Cambria, Fayette, Greene,
Pittsburgh, PA 15222-4745
Indiana,
Somerset,
Washington,
and
Westmoreland
(412) 442-4024
Northcentral Regional Office
Eastern District
208 W. Third Street, Suite 101
Adams, Bedford, Berks, Blair, Bradford, Bucks, Carbon,
Williamsport, PA 17701
Cameron, Centre, Chester, Clearfield, Clinton, Columbia,
(570) 321-6550
Cumberland,
Dauphin,
Delaware,
Franklin,
Fulton,
Huntingdon, Juniata, Lackawanna, Lancaster, Lebanon,
Lehigh, Luzerne, Lycoming, Mifflin, Monroe, Montgomery,
Montour,
Northampton,
Northumberland,
Perry,
Philadelphia, Pike, Potter, Schuylkill, Snyder, Sullivan,
Susquehanna, Tioga, Union, Wayne, Wyoming, and York
Environmental Assessment Forms not associated with oil and gas activities –
The Environmental Assessment Form and other associated documents must be sent to the appropriate DEP Waterways
and Wetlands Program, Regional Office listed below.
Waterways and Wetlands Program
County Responsibility
Northwest Regional Office
230 Chestnut Street
Butler, Clarion, Crawford, Elk, Erie, Forest, Jefferson,
Meadville, PA 16335
Lawrence,
McKean,
Mercer,
Venango,
and
Warren
(814) 332-6984
Southwest Regional Office
400 Waterfront Drive
Allegheny,
Armstrong,
Beaver,
Cambria,
Fayette,
Pittsburgh, PA 15222-4745
Greene, Indiana, Somerset, Washington, and Westmoreland
(412) 442-4000
Northcentral Regional Office
208 W. Third Street, Suite 101
Bradford, Cameron, Centre, Clearfield, Clinton, Columbia,
Williamsport, PA 17701
Lycoming,
Montour,
Northumberland,
Potter,
Snyder,
(570) 327-3574
Sullivan, Tioga, and Union

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APPENDIX II
REGIONAL OFFICES continued
Southcentral Regional Office
909 Elmerton Avenue, Second Floor
Adams, Bedford, Berks, Blair, Cumberland, Dauphin,
Harrisburg, PA 17110
Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon,
(717) 705-4802
Mifflin, Perry, and York
Northeast Regional Office
2 Public Square
Carbon,
Lackawanna,
Lehigh,
Luzerne,
Monroe,
Wilkes-Barre, PA 18711-0790
Northampton,
Pike,
Schuylkill,
Susquehanna,
Wayne,
(570) 826-2511
and Wyoming
Southeast Regional Office
2 East Main Street
Bucks, Chester, Delaware, Montgomery, and Philadelphia
Norristown, PA 19401
(484) 250-5970
DEP CENTRAL OFFICE
Bureau of Waterways Engineering and Wetlands
Division of Wetlands, Encroachments and Training
P.O. Box 8460
Harrisburg, PA 17105-8460
717-787-3411
Bureau of Waterways Engineering and Wetlands
Division of Dam Safety
P.O. Box 8460
Harrisburg, PA 17105-8460
717-787-8568

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APPENDIX III
U.S. ARMY CORPS OF ENGINEERS DISTRICT OFFICES
Ohio River Basin
Portions of Lake Erie and
Genesee River Basins
Located in PA
Susquehanna River Basin
Delaware River Basin
Pittsburgh District
Corps of Engineers
Regulatory Branch
Federal Building, 20
th
Floor
1000 Liberty Avenue
Pittsburgh, PA 15222
Phone: 412-395-7152
Fax:
412-644-4211
Baltimore District
Corps of Engineers
Pennsylvania Field Office
1631 South Atherton Street,
Suite 101
State College, PA 16801
Phone: 814-235-0570
Fax:
814-235-0576
Philadelphia District
Corps of Engineers
Regulatory Branch
Wanamaker Building
100 Penn Square East
Philadelphia, PA 19107
Phone: 215-656-6728
Phone: 215-656-6729
(to report violations)
Fax:
215-656-6724

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Appendix IV
Subfacility Codes and Descriptions
Subfacility
Authorized Activities/Structures
Location of
Lat/Long Point
Code
Name
BHGR
Bulkhead or
Groin
This subfacility must be used when solid fill bulkheads or other types
are constructed in or along waters of the Commonwealth. Groin
structures should also use this subfacility code.
Upstream point on
bank or shore
BRDG
Bridge
This subfacility must be used when a structure and its appurtenant
works is erected over regulated waters of the Commonwealth. Bridges
over 100 feet in u/s to d/s length will use this subfacility not the STENC.
Centroid of
proposed structure
or Point on bank
where crosses
water
CULV
Culvert
This subfacility must be used when a structure with appurtenant works
that carries a stream under or through an embankment or fill is
constructed. Culverts are 100 feet and less in length upstream to
downstream. Structures greater than 100 feet will use the
STENC
subfacility code.
Upstream point on
bank
CW
Channel
Work
This subfacility must be used for minor realignment work, channel
cleaning around water obstructions or minor channel work that is not
covered under another subfacility code.
Minor is defined as 50 linear
feet or less.
This code includes riprap channel approaches to
structures regardless of length.
Upstream point on
bank
DOCK
Dock
This subfacility must be used for all types of floating, cantilevered or
pile supported structures within regulated waters of the Commonwealth
that are constructed for docking purposes of a private, public or
commercial nature. Boat Launch Ramps independently built or in
conjunction with a dock should use the RAMP subfacility code
Upstream point on
bank or shore
DRG
Dredging
This subfacility must be used for activities that remove sand, gravel,
mud or other materials from beds of regulated waters of the
Commonwealth.
This does not include gravel bar removal
. The
GBR
subfacility code should be used for these activities.
Upstream point on
bank or shore
FILSC
Fill Stream
Channel
This subfacility should be used when recording stream channel fills that
would otherwise be waived. This is done for SPGP reporting purposes
to meet single and complete project disclosure requirements.
Upstream most
point
FLACT
Floodway
Activity
This subfacility must be used for activities or structures encroaching
upon or obstructing the floodway.
This does not include levees,
dikes or floodwalls.
The
FLVWL
subfacility will be used for these
activities.
Centroid of area or
structure
FLPL
Ch. 106
Floodplain
Permit
This subfacility will be used for municipal applications as required
under Chapter 106.
Centroid of area or
structure
FLPRT
Flood
Protection
Project
This subfacility will be used for flood protection projects that modify the
stream channel.
Levees and floodwalls should use the FLVWL
subfacility code.
Upstream point on
bank
FLVWL
Flood Levee
or Walls
This subfacility must be used for the construction of levees, dikes,
floodwalls or other such devices for controlling or directing floodwaters
to a defined area or direction.
Upstream point on
bank
FORD
Ford
Crossing
This subfacility must be used for activities where road crossings utilize
the existing streambed whether for commercial or private use.
Centroid of stream
or Point on bank
where enters water

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 23 -
GBR
Gravel Bar
Removal
This subfacility must be used specifically for the removal of gravel bars
within channels. This subfacility should not be used for dredging
activities. Gravel bar excavation does not occur below the plane of
ordinary water levels while dredging does.
Upstream point on
bank
INTAK
Intake
Structure
This subfacility must be used for structures and appurtenant works that
convey water from a stream or body of water through a pipe or channel
constructed for that purpose.
Point on bank
where enters water
NJD
Non-
Jurisdictional
Dam
This subfacility must be used when non-jurisdictional dams are
approved either through an environmental assessment or in
conjunction with other water obstruction and encroachments activities.
Wetland impact subfacility must be used in conjunction with this
subfacility when a dam affects wetland resources whether temporary
or permanent in nature.
Centroid of
proposed structure
or Point on bank
OTHER Other
Activities
This subfacility must only be used when one of the other subfacility
codes does not adequately cover the activity or structure. A description
of the activity and pertinent data must be entered in the comment field
to adequately describe what is authorized.
Centroid of area,
point on bank,
shore or other such
appropriate location
OUTFL
Outfall
Structure
This subfacility must be used for structures and appurtenant works that
convey water, stormwater or wastewater into a stream or body of water
through a pipe or channel constructed for that purpose.
Point on bank
where enters water
PIPE
Pipeline or
Conduit
This subfacility must be used for any pipe or pipeline constructed for
the transportation of a gaseous, liquid, liquefiable or slurry substance
or, any cable, conduit, line or wire for the transmission of electrical
energy, telephone, telegraph, radio or television signals including
cathodic corrosion protection placed in, along, under, across or over
regulated waters of the Commonwealth.
Centroid of
proposed structure
(stream) or Point on
bank where enters
water
RAMP
Boat Launch
Ramp
Boat Launch Ramps will use this subfacility whether in conjunction with
or independent of a docking structure.
Point on bank
where enters water
SBP
Stream Bank
Protection
This subfacility must be used for activities or structures authorized
individually or in conjunction with other activities or structures that
involve rehabilitation or protection of the bank(s) of regulated waters of
the Commonwealth against erosion, scour or sloughing by utilizing
slope protection, dumped rock, cribbing, walls, channel deflectors or
vegetative stabilization techniques.
Upstream point on
bank
STENC Stream
Enclosure
This subfacility must be used for a structure more than 100 feet in
length, upstream to downstream, that encloses regulated waters of the
Commonwealth.
Bridges are excluded from this category
and the
BRDG
subfacility code will be used.
Upstream point on
bank
STREL
Stream
Relocation
This subfacility must be used when a new channel is constructed for
the purpose of relocating stream flows from the original (or current)
channel. Temporary relocations can use this subfacility by using a
status code of Temporary (status code will be added to LOV). This
does not apply to stream restoration projects use the STRS subfacility
code.
Upstream point on
bank
STRS
Stream
Restoration
This subfacility is currently ambiguous and may be modified for clarity.
Individual project restoration segments should be represented with
their own individual subfacility.
Upstream point on
bank
STRDR Stream
Restoration
with Dam
Removal
This subfacility is used by the Dam Safety program for recording
stream restoration activities associated with the removal of
jurisdictional and non-jurisdictional dams.
Upstream point on
bank
TMPWI
Temporary
Wetland
Impact
This subfacility must be used when direct or indirect impacts to
wetlands occur on a temporary basis. This code does not apply to
utility line crossings of wetlands (see WTIM).
Center of area

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 24 -
TRWET Treatment
Wetland
System
This subfacility must be used when the construction of a wetland
treatment system within regulated waters of the Commonwealth is
authorized.
Center of area
WETRE Wetland
Restoration
This subfacility must be used for
all
wetland creation, replacement or
restoration efforts approved or required. Wetland Restoration is used
as a generic term for the purposes of eFACTS. This subfacility should
also be used when PWRP or WMB subfacility are authorized as
compensation.
Center of area
WTDIM Wetland
Direct Impact
This subfacility must be used for
all
direct permanent wetland impacts
regardless of their nature or size. Activities such as fills,
excavation
,
inundation, draining, infiltration trenches, etc.
Wetland Impact
is used
as a generic term for the purposes of eFACTS.
Center of area
WTIIM
Wetland
Indirect
Impact
This subfacility must be used for
all
indirect permanent wetland
impacts regardless of their nature or size. Activities such as fills,
excavation
, inundation, draining, infiltration trenches, etc.
Wetland
Impact
is used as a generic term for the purposes of eFACTS.
Center of area

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 25 -
Appendix V
Subfacility Details
Subfacility
Authorized Activities/Structures
Code
Name
WTDIM Wetland
Direct Impact
This subfacility must be used for
all
direct permanent wetland impacts regardless of their
nature or size. Activities such as fills,
excavation
, inundation, draining, infiltration
trenches, etc.
Wetland Impact
is used as a generic term for the purposes of eFACTS.
WTIIM
Wetland
Indirect
Impact
This subfacility must be used for
all
indirect permanent wetland impacts regardless of
their nature or size. Activities such as fills,
excavation
, inundation, draining, infiltration
trenches, etc.
Wetland Impact
is used as a generic term for the purposes of eFACTS.
Table Template Example
Subfacility Type
WTDIM
Wetland Direct Impact
Id
W1A
Wetland 1 Impact Area
County
Bedford
Municipality
Hopewell
Latitude Degrees
40
Latitude Minutes
7
Latitude Seconds
49
Longitude Degrees
-78
Longitude Minutes
19
Longitude Seconds
58
Impacted Area
0.02
Classification
PEM
Palustrine Emergent
Reg Classification
OW
Other Wetlands
Field Name and Description
Impact Area -
The amount of wetland acreage that is permanently or temporarily affected. The amount
must be between
0.01
and
999.99
and in the format 999.99.
Classification Type Code -
The code used to identify the
Cowardin classification of the compensated area. Duplicate
classification type codes are not allowed for the same sub
facility.
Classification Type Code Description -
The corresponding
description for the classification type code.
CODE
DESCRIPTION
PAB
Palustrine Aquatic Bed
PEM
Palustrine Emergent
PFL
Palustrine Flat
PFO
Palustrine Forested
PSS
Palustrine Scrub/Shrub
Regulatory Classification Code -
The code used to identify the regulatory
classification of the impacted area.
Regulatory Classification Code Description -
The corresponding
description for the regulatory classification code.
CODE
DESCRIPTION
EV
Exceptional Value
OW
Other Wetlands
Subfacility
Authorized Activities/Structures
Code
Name
WETRE
Wetland
Restoration
This subfacility must be used for
all
wetland creation, replacement or restoration efforts
approved or required. Wetland Restoration is used as a generic term for the purposes
of eFACTS. This subfacility should also be used when PWRP or WMB subfacility are
authorized as compensation.

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 26 -
Table Template Example
Subfacility Type
WETRE
Wetland Restoration
Id
WM1A
Wetland Mitigation Area 1A
County
Delaware
Municipality
Aston
Latitude Degrees
39
Latitude Minutes
51
Latitude Seconds
28.8
Longitude Degrees
-75
Longitude Minutes
24
Longitude Seconds
23.6
Replacement Area
0.51
Classification
Palustrine Forested
WR Project Objectives
2:1 RATIO OF IMPACTED WETLANDS PFO TYPE
Replacement Area -
The amount of wetland acreage required to compensate for impacts. The area must
be between 0.01 and 999.99 and in the format 999.99.
Classification Type Code -
The code used to identify the
Cowardin classification of the compensated area. Duplicate
classification type codes are not allowed for the same sub
facility.
Classification Type Code Description -
The corresponding
description for the classification type code.
CODE
DESCRIPTION
PAB
Palustrine Aquatic Bed
PEM
Palustrine Emergent
PFL
Palustrine Flat
PFO
Palustrine Forested
PSS
Palustrine Scrub/Shrub
WR Project Objectives -
A free-form text field to enter the project objectives.
Subfacility
Authorized Activities/Structures
Code
Name
BRDG
Bridge
This subfacility must be used when a structure and its appurtenant works is erected over
regulated waters of the Commonwealth. Bridges over 100 feet in u/s to d/s length will use
this subfacility not the STENC.
CULV
Culvert
This subfacility must be used when a structure with appurtenant works that carries a
stream under or through an embankment or fill is constructed. Culverts are 100 feet and
less in length upstream to downstream. Structures greater than 100 feet will use the
STENC
subfacility code.
STENC
Stream
Enclosure
This subfacility must be used for a structure more than 100 feet in length, upstream to
downstream, that encloses regulated waters of the Commonwealth.
Bridges are
excluded from this category
and the
BRDG
subfacility code will be used.
FORD
Ford
Crossing
This subfacility must be used for activities where road crossings utilize the existing
streambed whether for commercial or private use.

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 27 -
Table Template Example
Subfacility Type
BRDG
Bridge
Id
B1
SR134 Bridge
County
Bedford
Municipality
Hopewell
Latitude Degrees
40
Latitude Minutes
7
Latitude Seconds
49
Longitude Degrees
-78
Longitude Minutes
19
Longitude Seconds
58
Design Flood Event
25
Twenty-Five Year Storm Event
Design Flood Flow
4667
Hydrologic Method
USGS
USGS Method
Design Flood Elevation
965.0
Hydraulic Method
HECRA
HEC -RAS
Drainage Area
4,158
Replacement of Existing Structure?
No
Foot Print Width
74.9
Foot Print Length
33
Total Impact Length
35
Structure Type
SS
Single Span
No. Waterway Openings
1
WOB Material
STBM
Steel Beam
Waterway Openings Diameter; or
0
Appurtenant
Structure
UWW
Upstream Wing Walls
Waterway Openings Height; and
9.6
Appurtenant
Structure
DWW
Downstream Wing
Walls
Waterway Openings Width
77.6
Field Name and Description
Design Flood: Event Code -
The code that identifies the flood
event for which the structure will pass or was evaluated for
during the review.
CODE
DESCRIPTION
10
Ten Year Storm Event
100
One Hundred Year Storm Event
25
Twenty-five Year Storm Event
50
Fifty Year Storm Event
Design Flood: Flow -
The amount of flow, measured in CFS, occurring during the design flood event.
The flow must be greater than zero and in the format 99,999,999.99.
Design Flood: Event Elevation -
The elevation, measured in USGS Datum, of the flood event if
available. The elevation must be greater than zero and in the format 99,999.9.
Drainage Area -
The drainage area, measured in acres, upstream of the reviewed structure. The area
must be greater than zero and in the format 999,999,999.99.
Repl Existing Structure -
A checkbox indicating whether an existing structure is being replaced with a
new one of the same or similar size. A ‘?’ (yes) indicates that an existing structure is being replaced. A
blank (no) indicates that an existing structure is not being replaced. The checkbox defaults to null (no).
Footprint: Width -
The width of the surface space occupied by the structure (measured perpendicular
to stream flow). The width must be greater than zero and in the format 99,999.99.
Footprint: Length -
The length of the surface space occupied by the structure (measured upstream to
downstream or parallel to stream flow). The length must be greater than zero and in the format
99,999.99.

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 28 -
Field Name and Description
Hydrologic Meth Code -
The code used to identify the hydrologic method
used during the review.
CODE
DESCRIPTION
EMF2
EMF-2
FEMAA FEMA Adjusted
HEC1
HEC-1
HECHM HEC-HMS
LINRG
Linear Regression
NA
Not Applicable
OTHER Other Methodology
PSU4
PSU-4
RATME Rational Method
TR20
SCSTR-20
TR55
TR-55
USGS
USGS Method
Hydraulic Meth Code -
The code used to identify the hydraulic
method used during the review.
CODE
DESCRIPTION
CULVM Culvert Master
FHDS5 FHWA HDS - 5
FLWM
Flow Master
HEC15 HEC - 15
HEC2
HEC - 2
HECRA HEC -RAS
HY8
HY - 8
NA
Not Applicable
OTHER Other Hydraulic Methodology
Total Length of Impact -
The total length of area that is impacted by the structure. The length of the
surface space occupied by the structure and any appurtenance works both upstream and downstream,
measured upstream to downstream or parallel to stream flow. The length must be greater than zero and
in the format 99,999.99.
Type of Structure Code -
The code used to identify the general type
of structure.
Type of Structure Code Description -
The corresponding
description for the type of structure.
CODE
DESCRIPTION
BOX
Box Culvert
CONAR Concrete Arched Culvert
ELLP
Elliptical Pipe
MS
Multiple Span
OBTM
Open Bottom Structure
PIPAR
Arched Pipe
PIPE
Pipe
SS
Single Span
SUSP
Suspension

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 29 -
Field Name and Description
Material Used Code -
The code used to identify the structure’s
general material makeup. Duplicate materials used codes are not
allowed for the same sub facility.
Material Used Code Description -
The corresponding description
for the materials used code.
CODE
DESCRIPTION
CMP
Corrugated Metal Pipe
CON
Concrete
HDPE
HDPE Plastic
MTPL
Metal Plate
OPLAS Other Plastic
PSCON Prestressed Concrete
PVC
Poly Vinyl Chlorinated Pipe
STBM
Steel Beam
SWP
Synthetic Wood Products
TWP
Timber or Wood Products
Appurtenant Structure Code -
The code used to identify the
appurtenant structure(s) associated with the reviewed structure.
Include both upstream and downstream codes when specified.
Duplicate appurtenant structure codes are not allowed for the same
sub facility.
Appurtenant Structure Code Description -
The corresponding
description for the appurtenant structure code.
CODE
DESCRIPTION
CBD
Concrete Bed Paving
CUW
Cutoff Wall
DWW Downstream Wing Walls
GRRR Grouted Rock Riprap
HW
Head Wall
RRRA Rock Riprap Aprons
UWW Upstream Wing Walls
Mitigation Measure Code -
The code used to identify the mitigation
measure voluntarily employed or required as part of the structure
itself. Duplicate mitigation measure codes are not allowed for the
same sub facility.
Mitigation Measure Code Description -
The corresponding
description for the mitigation measure code.
CODE
DESCRIPTION
12ID
12 inch Invert Depression
6ID
6 inch Invert Depression
AER
Aerators
LFCH
Low Flow Channel System
LFWR
Low Flow Weir System
OBAFF Offset Baffles
XID
Other Invert Depression
# Opening -
The number of waterway openings sharing the same dimensions. The opening must be
greater than zero and in the format 99.
Width -
The width of the waterway opening, measured in feet. The width must be greater than zero and
in the format 9,999.9.
Height -
The height of the waterway opening, measured in feet. The height must be greater than zero
and in the format 9,999.9.
Diameter -
The diameter of the pipe, measured in feet. The diameter must be greater than zero and in
the format 999.9.

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 30 -
Subfacility
Authorized Activities/Structures
Code
Name
INTAK
Intake
Structure
This subfacility must be used for structures and appurtenant works that convey water
from a stream or body of water through a pipe or channel constructed for that purpose.
OUTFL
Outfall
Structure
This subfacility must be used for structures and appurtenant works that convey water,
stormwater or wastewater into a stream or body of water through a pipe or channel
constructed for that purpose.
Table Template Example
Subfacility Type
OUTFL
Outfall Structure
Id
OF1
OUTFALL 1
County
Susquehanna
Municipality
Clifford
Latitude Degrees
41
Latitude Minutes
38
Latitude Seconds
56.7
Longitude Degrees
-75
Longitude Minutes
35
Longitude Seconds
57.4
Intake/Outfall Type
SW
Stormwater
Velocity
6.4
WOB Material
OPLAS
Other Plastic
Capacity
11.4
Diameter
1.5
Structure Width
20
Pipe Length
35
Protective
Measures
RRR
Rock Riprap
Location
BANK
Field Name and Description
Type -
The code used to identify the type of intake or
outfall.
CODE
DESCRIPTION
FP
Fire Protection
IC
Industrial Cooling
IP
Industrial Processing
IRR
Irrigation
PW
Potable Water (Raw Water Intake)
REC
Recreational Source
SEW
Sewerage
SW
Stormwater
WQTS Water Quality Treatment System

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 31 -
Field Name and Description
Material Code -
The code used to identify the structure’s general
material makeup.
Material Code Description -
The corresponding description for
the material code.
CODE
DESCRIPTION
CMP
Corrugated Metal Pipe
CON
Concrete
HDPE
HDPE Plastic
MTPL
Metal Plate
OPLAS Other Plastic
PSCON Prestressed Concrete
PVC
Poly Vinyl Chlorinated
Pipe
STBM
Steel Beam
SWP
Synthetic Wood Products
TWP
Timber or Wood Products
Capacity -
The maximum approved intake or discharge capacity of the structure. The capacity must be
greater than zero, between 0.1 and 9,999,999.9, and in the format 9,999,999.99.
Diameter -
The diameter of the pipe in feet. The diameter must be greater than zero and in the format
99.9.
Structure Width -
The upstream to downstream “length” of the structure stabilizing the intake or
discharge pipe or the width of an outfall channel. The width must be greater than zero, between 0.1 and
999.9, and in the format 999.9.
Pipe Length -
The length of any instream pipe or the length of the outfall channel leading to the
mainstream channel.
The length must be greater than zero in the format 99,999.
Velocity -
The maximum velocity of discharge or intake attainable. The velocity must be greater than
zero and in the format 999,999.9.
Location of Intake/Outfall: -
A radio button indicating the location of the pipe opening. Outfall channels
are identified using the
BANK
RADIO button. Instream channels are identified using the
INSTREAM
RADIO button. All other locations are identified using the
OTHER
RADIO button.
Protective Measure Code -
The code used to identify any protective measures
employed. Duplicate protective measure codes are not allowed for the same
sub facility.
Protective Measure Code Description -
The corresponding description for
the protective measures code.
CODE DESCRIPTION
EMBD Embedded
ENCA Encased
RRR
Rock Riprap
SCRN Screened

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 32 -
Subfacility
Authorized Activities/Structures
Code
Name
PIPE
Pipeline or
Conduit
This subfacility must be used for any pipe or pipeline constructed for the transportation
of a gaseous, liquid, liquefiable or slurry substance or, any cable, conduit, line or wire for
the transmission of electrical energy, telephone, telegraph, radio or television signals
including cathodic corrosion protection placed in, along, under, across or over regulated
waters of the Commonwealth.
Table Template Example
Subfacility Type
PIPE
Pipeline or Conduit
Id
UT1
SR 2018 SEC A10 UTILITY LINE
County
Washington
Municipality
North Charleroi
Latitude Degrees
40
Latitude Minutes
9
Latitude Seconds
6
Longitude Degrees
-79
Longitude Minutes
54
Longitude Seconds
15
Pipe Conduit Type
AER
Aerial
Attached Water Obstruction?
Yes
Product
CBFOP
Cable, Fiber Optic or Phone
Diameter
1
Row Width
1
Pipe Length
500
Cover Depth
0
Line Encased
No
Shut Off Controls
No
Field Name and Description
Type -
The code used to best represent the method of pipe crossing
employed.
CODE
DESCRIPTION
AER
Aerial
ATT
Attached
COVAC Covered above Culvert
COVBC Covered below Culvert
COVD
Covered
DB
Directional Bore/Drill
EXPD
Exposed
OTHER Other
TRNC
Open Trenched
Product Code -
The code used to identify the product.
Product Code Description -
The corresponding description for
the product code.
CODE
DESCRIPTION
CBFOP Cable, Fiber Optic or Phone
CHEM
Chemical
ELEC
Electrical
OTHER Other
PETRO Petroleum, Nat Gas, Oil, etc
PW
Potable Water
SEW
Sewerage
Diameter -
The diameter of the pipe/conduit crossing in feet.
The diameter must be greater than zero and in the format 99.9.

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 33 -
Field Name and Description
Depth of Cover -
The depth of cover over the pipe/conduit measured from the stream invert. The depth
of cover must be greater than zero and in the format 999.9.
Line Encased? -
A checkbox indicating whether the line is encased in concrete. A ‘?’ (yes) indicates
that the line is encased in concrete. A blank (no) indicates that the line is not encased in concrete. The
checkbox defaults to null (no).
Shut Off Controls? -
A checkbox indicating whether there are shutoff controls employed or required. A
‘?’ (yes) indicates that shut off controls are employed or required. A blank (no) indicates that shut off
controls are not employed or required. The checkbox defaults to null (no).
Attached to Water Obstruction? -
A checkbox indicating the pipe/conduit is attached to another water
obstruction.
A ‘?’ (yes) indicates that the pipeline or conduit is attached to a water obstruction. A blank (no) indicates
that pipeline or conduit is not attached to a water obstruction. The checkbox defaults to null (no).
ROW Width -
The upstream to downstream length of the streambed used for construction or
maintenance. The width must be greater than zero and in the format 9999.
Pipe/Cond Length -
The length of the pipe or conduit crossing the stream or body of water. The length
must be greater than zero and in the format 99,999.9.

3150-PM-BWEW0017
Rev. 6/2017
Instructions
- 34 -
Subfacility
Authorized Activities/Structures
Code
Name
BHGR
Bulkhead or
Groin
This subfacility must be used when solid fill bulkheads or other types are constructed in
or along waters of the Commonwealth. Groin structures should also use this subfacility
code.
SBP
Stream Bank
Protection
This subfacility must be used for activities or structures authorized individually or in
conjunction with other activities or structures that involve rehabilitation or protection of
the bank(s) of regulated waters of the Commonwealth against erosion, scour or
sloughing by utilizing slope protection, dumped rock, cribbing, walls, channel deflectors
or vegetative stabilization techniques.
Table Template Example
Subfacility Type
SBP
Stream Bank Protection
Id
SBP01
UNT BANK STABILIZATION
County
Bedford
Municipality
Hopewell
Latitude Degrees
40
Latitude Minutes
7
Latitude Seconds
51.63
Longitude Degrees
-78
Longitude Minutes
20
Longitude Seconds
1.67
Bank Type
Activity Length
Stabilization Method
Right
407
RRR
Rock Riprap
Left
240
RRR
Rock Riprap
Field Name and Description
Method Code -
The code used to identify the
method of stabilization or construction. Duplicate
method code and R/L bank indicator combinations
are not allowed for the same sub facility.
Method Code Description -
The corresponding
description for the method.
CODE
DESCRIPTION
BIOLG Bio-Logs
COMB Combined structural and vegetation materials
CONC Concrete
DRS
Dumped Rock or Stone
GABB Gabion Baskets
OTHER Other Material
RPCR Riparian Corridor Restoration
RRR
Rock Riprap
SP
Sheet Piling
TWP
Timber or Wood Products
VEG
Vegetative Plantings
Length of Activity -
The length of the activity that took place. The length must be greater than zero
and in the format 99,999.9.
R/L Bank -
Indicates the stream bank side where the activity took place. The indicator defaults to
blank (null).
Duplicate method code and R/L bank indicator combinations are not allowed for the same sub facility.

3150-PM-BWEW0017
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Instructions
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Subfacility
Authorized Activities/Structures
Code
Name
CW
Channel
Work
This subfacility must be used for minor realignment work, channel cleaning around water
obstructions or minor channel work that is not covered under another subfacility code.
Minor is defined as 50 linear feet or less.
This code includes riprap channel
approaches to structures regardless of length.
FILSC
Fill Stream
Channel
This subfacility should be used when recording stream channel fills that would otherwise
be waived. This is done for SPGP reporting purposes to meet single and complete
project disclosure requirements.
STREL
Stream
Relocation
This subfacility must be used when a new channel is constructed for the purpose of
relocating stream flows from the original (or current) channel. Temporary relocations can
use this subfacility by using a status code of Temporary (status code will be added to
LOV). This does not apply to stream restoration projects use the STRS subfacility code.
STRS
Stream
Restoration
This subfacility is currently ambiguous and may be modified for clarity. Individual project
restoration segments should be represented with their own individual subfacility.
Table Template Example
Subfacility Type
STRS
Stream Restoration
Id
STRS01
S.R. 1045 NATURAL CHANNEL
STABILIZATION
County
Susquehanna
Municipality
Clifford
Latitude Degrees
40
Latitude Minutes
10
Latitude Seconds
29
Longitude Degrees
-76
Longitude Minutes
11
Longitude
Seconds
41
Structure Code and Description
Activity Length
Number Installed
CRVN
Cross Vane
350
10
Field Name and Description
Instream Structure Code -
The code used to identify the type of instream
structure. Duplicate instream structure codes are not allowed for the same
sub facility.
Instream Structure Code Description -
The corresponding description for
the instream structure.
CODE
DESCRIPTION
BLDR Boulder Deflector
CRVN Cross Vane
DEFL
Deflector
JHK
J Hook
LGVN Log Vane
MDSL Mud Sill
RKVN Rock Vane
RTWD Root wads
WWR
W Weir
Number Installed -
The number of instream structures installed. The number must be greater than zero
and in the format 999.
Length of Activity -
The overall upstream to downstream length, within which the activity occurs. The
length must be greater than zero and in the format 999,999.9.

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Instructions
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Field Name and Description
Channel Modifications Code -
The code used to
identify the type of channel modification.
Duplicate channel modifications codes are not
allowed for the same sub facility.
Channel Modifications Code Description -
The
corresponding
description
for
the
channel
modification code.
CODE
DESCRIPTION
ARLMT Approach Realignment
CCL
Concrete Channel Lining
CCR
Concrete Cabled Revetment
FGM
Fluvial Geomorphology Designed Restoration
FSC
Fill Stream Channel
RRRCL Rock Riprap Channel Lining
SEDRE Sediment Removal (mill races and canals)
SINKR
Sinkhole Repair
Length of Activity -
The upstream to downstream length of the activity. The length must be greater than
zero and in the format 999,999.9.
Avg. Width of Activity -
The average stream width along the activity. The width must be greater than
zero and in the format 999.9.
Subfacility
Authorized Activities/Structures
Code
Name
DRG
Dredging
This subfacility must be used for activities that remove sand, gravel, mud or other
materials from beds of regulated waters of the Commonwealth.
This does not include
gravel bar removal
. The
GBR
subfacility code should be used for these activities.
GBR
Gravel Bar
Removal
This subfacility must be used specifically for the removal of gravel bars within channels.
This subfacility should not be used for dredging activities. Gravel bar excavation does not
occur below the plane of ordinary water levels while dredging does.
Table Template Example
Subfacility Type
GBR
Gravel Bar Removal
Id
GBR01
IN-STREAM
County
Susquehanna
Municipality
Clifford
Latitude Degrees
41
Latitude Minutes
38
Latitude Seconds
56.5
Longitude Degrees
-75
Longitude Minutes
35
Longitude Seconds
57.7
Gravelbar or Maintenance Dredging Length
55
Width
14.5
Depth
2
Total Bar Area
.1
River Pool
n/a
River Mile From
River Mile To
Right Side
n/a
n/a
n/a
Left Side
n/a
Offset Restriction
n/a
n/a
Buffer Width
n/a

3150-PM-BWEW0017
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Instructions
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Length -
The upstream to downstream length of the gravel bar or maintenance dredging location. The
length must be greater than zero and in the format 99,999.9.
Avg. Width -
The width of the gravel bar or maintenance dredging area, measured as perpendicular to
stream flow.
The width must be greater than zero and in the format 999.9.
River Pool Code -
The code used to identify the river
pool where commercial or navigational dredging is
occurring.
River Pool Code Description -
The corresponding
description for the river pool code.
CODE
DESCRIPTION
MRBRP Mononghahela River Braddock Pool
MREMP Mononghahela River Emsworth Pool
MRGLP Mononghahela River Grays Landing Pool
MRMWP Mononghahela River Maxwell Pool
MRP2
Mononghahela River Pool 2
MRP3
Mononghahela River Pool 3
MRP4
Mononghahela River Pool 4
MRPMP Mononghahela River Point Marion Pool
ORDAP Ohio River Dashields Pool
OREMP Ohio River Emsworth Pool
ORMNP Ohio River Montgomery Pool
ORNCP Ohio River New Cumberland Pool
DELR
Delaware River
CODE
DESCRIPTION
AREMP Allegheny River Emsworth Pool
ARP2
Allegheny River Pool 2
ARP3
Allegheny River Pool 3
ARP4
Allegheny River Pool 4
ARP5
Allegheny River Pool 5
ARP6
Allegheny River Pool 6
ARP7
Allegheny River Pool 7
ARP8
Allegheny River Pool 8
ARP9
Allegheny River Pool 9
Offset Restriction Type Code -
The code used to identify
the offset restrictions required when conducting dredging
activities for commercial or navigational purposes.
Duplicate offset restriction type codes are not allowed for
the same sub facility.
Offset Restriction Type Code Description -
The
corresponding description for the offset restriction type
code.
CODE
DESCRIPTION
BIO
Biological
BP
Bridge Pier
IND
Industrial
ISL
Island
MUSS Valid/Current Mussel Survey Required
NAV
Navigational
NPS
Normal Pool Shore
UTIL
Utility
Buffer Width -
The amount of buffer required in feet with an associated offset restriction. The width
must be greater than zero and in the format 9,999.9.
Id -
The unique, system-generated identification number assigned to the river mile record.
From -
The downstream river mile limit of dredging for a given area. The from entry must be greater
than zero and in the format 999.99.
To -
The upstream river mile limit of dredging for a given area. The to entry must be greater than zero
and in the format 999.99. The to entry must be greater than or equal to the from entry.
Left -
A checkbox indicating the left channel side looking upstream where dredging is authorized. A ‘?’
(yes) indicates that the river mile is determined from the left channel side. A blank (no) indicates that the
river mile is not determined from the left channel side. The checkbox defaults to null (no).
Right -
A checkbox indicating the right channel side looking upstream where dredging is authorized. A
‘?’ (yes) indicates that the river mile is determined from the right channel side. A blank (no) indicates
that the river mile is not determined from the right channel side. The checkbox defaults to null (no).

3150-PM-BWEW0017
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Instructions
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Subfacility
Authorized Activities/Structures
Code
Name
FLACT
Floodway
Activity
This subfacility must be used for activities or structures encroaching upon or obstructing
the floodway.
This does not include levees, dikes or floodwalls.
The
FLVWL
subfacility will be used for these activities.
FLPL
Ch. 106
Floodplain
Permit
This subfacility will be used for municipal applications as required under Chapter 106.
FLVWL
Flood Levee
or Walls
This subfacility must be used for the construction of levees, dikes, floodwalls or other such
devices for controlling or directing floodwaters to a defined area or direction.
Table Template Example
Subfacility Type
FLPL
Ch. 106 Floodplain Permit
Id
FLPL01
ROADWAY FILL IN THE FLOODPLAIN
County
Lancaster
Municipality
Mount Joy
Latitude Degrees
40
Latitude Minutes
11
Latitude Seconds
8.31
Longitude Degrees
-76
Longitude Minutes
30
Longitude Seconds
56.17
Floodway Method
50 Foot Rule
Design Flood Event
10 Year Storm
Free Board Height
Flowage Easement
No
Protection Measures
No
Interior Drainage
No
Left Width
15
Left Length
160
Left Height
3
Right Width
7
Right Length
100
Right Height
3
Field Name and Description
Floodway Determination Method Code -
The code used to
identify the floodway determination method.
Floodway Determination Method Code Description -
The
corresponding description for the floodway determination method
code.
CODE
DESCRIPTION
FEMA
FEMA Mapped Floodway
50RU
Fifty Foot Rule
OTHER Other Determination Method
Design Flood Event Code -
The code used to identify the design
flood event.
Design Flood Event Code Description -
The corresponding
description for the design flood event code.
CODE
DESCRIPTION
10
Ten Year Storm Event
100
One Hundred Year Storm Event
25
Twenty-five Year Storm Event
50
Fifty Year Storm Event
Flowage Easement Required -
A checkbox indicating whether flowage easement is required as a result
of the activity. A ‘?’ (yes) indicates that flowage easement is required. A blank (no) indicates that flowage
easement is not required. The checkbox defaults to null (no).
Erosion Protection Measures -
A checkbox indicating whether erosion protection measures are required
due to potential increased velocities of the approved activity. A ‘?’ (yes) indicates that erosion protection
measures are required. A blank (no) indicates that erosion protection measures are not required. The
checkbox defaults to null (no).
Interior Drainage -
A checkbox indicating whether interior drainage is required for the levee or similar
structure. A ‘?’ (yes) indicates that interior drainage is required. A blank (no) indicates that interior
drainage is not required. The checkbox defaults to null (no).
Free Board Height -
The free board height of the structure above flood design event in feet. The height
must be greater than zero and in the format 99.9.

3150-PM-BWEW0017
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Instructions
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Field Name and Description
Left Side Width -
The width of the structure in feet on the left side of the stream when looking upstream,
measured perpendicular to flow. The width must be greater than zero and in the format 99,999.
Left Side Length -
The length of the structure in feet on the left side of the stream when looking upstream,
measured parallel to stream flow. The length must be greater than zero and in the format 99,999.
Left Side Height -
The height of the structure in feet on the left side of the stream when looking upstream.
The height must be greater than zero and in the format 999.9.
Right Side Width -
The width of structure in feet on right side of stream when looking upstream, measured
perpendicular to flow. The width must be greater than zero and in the format 99,999.
Right Side Length -
The length of the structure in feet on the left side of the stream when looking
upstream, measured parallel to stream flow. The length must be greater than zero and be in the format
99,999.
Right Side Height -
The height of the structure in feet on the left side of the stream when looking upstream.
The height must be greater than zero and be in the format 999.9.
Subfacility
Authorized Activities/Structures
Code
Name
DOCK
Dock
This subfacility must be used for all types of floating, cantilevered or pile supported
structures within regulated waters of the Commonwealth that are constructed for docking
purposes of a private, public or commercial nature. Boat Launch Ramps independently
built or in conjunction with a dock should use the RAMP subfacility code
RAMP
Boat Launch
Ramp
Boat Launch Ramps will use this subfacility whether in conjunction with or independent
of a docking structure.
Table Template Example
Subfacility Type
DOCK
Dock
Id
DOCK01
SR 2018 SECTION A10 FLOATING DOCK
County
Susquehanna
Municipality
North Charleroi
Latitude Degrees
40
Latitude
Minutes
9
Latitude Seconds
6
Longitude Degrees
-79
Longitude
Minutes
54
Longitude Seconds
15
Dock Facility
Purpose
Private
Total Facility Area
1
Total Facility
Width
8
Total Facility
Length
50
Total Mooring Area
1
Total Mooring
Width
8
Total Mooring
Length
50

3150-PM-BWEW0017
Rev. 6/2017
Instructions
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Field Name and Description
Purpose Code -
The code used to identify the purpose of the facility.
Purpose Code Description -
The corresponding description for the
purpose code.
CODE
DESCRIPTION
COMM Commercial
IND
Industrial
PRIV
Private
PUREC Public Recreational
PUSAF Public Safety
UTIL
Public Utility
Facility Type Code -
The code used to identify the facility
type.
Facility Type Code Description -
The corresponding
description for the facility type code.
CODE
DESCRIPTION
BDWK
Boardwalk
CANT
Cantilevered
CAPCO Cast in Place Concrete
COPR
Concrete Pier/Wharf
FLO
Floating
NATSB Natural Substrate
PIMO
Pile Mooring Only
PISU
Pile Supported
PRCON Precast Concrete Launch Ramp
ROCK
Rock or Gravel
SFB
Solid Filled Barge
SFPR
Solid Fill Pier
STPR
Steel Pier/Wharf
WOPR
Wooden Pier/Wharf
Total Facility Area: Area -
The total area in acres occupied by the sub facility. The area must be greater
than zero and be in the format 99,999.
Total Facility Area: Width -
The overall width of the structure in feet measured perpendicular to stream
flow or from bank if other waters. The width must be greater than zero and in the format 9,999.9.
Total Facility Area: Length -
The overall length of the structure in feet measured parallel to stream flow
or bank if other waters. The length must be greater than zero and in the format 9,999.9.
Total Mooring Area: Area -
The total area in acres for mooring areas. The area must be greater than
zero and in the format 99,999.
Total Mooring Area: Width -
The overall width of the mooring area in feet measured perpendicular to
stream flow or from bank if other waters. The width must be greater than zero and in the format 9,999.9.
Total Mooring Area: Length -
The overall length of the mooring area in feet measured parallel to stream
flow or bank if other waters. The length must be greater than zero and in the format 9,999.9.
Navigable Stream -
A checkbox indicating whether the sub facility is located on a navigable stream. A
‘?’ (yes) indicates that the sub facility is located on a navigable stream. A blank (no) indicates that the
sub facility is not located on a navigable stream. The checkbox defaults to null (no).

3150-PM-BWEW0017
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Instructions
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Subfacility
Authorized Activities/Structures
Code
Name
NJD
Non-
Jurisdictional
Dam
This subfacility must be used when non-jurisdictional dams are approved either through
an environmental assessment or in conjunction with other water obstruction and
encroachments activities. Wetland impact subfacility must be used in conjunction with this
subfacility when a dam affects wetland resources whether temporary or permanent in
nature.
STRDR Stream
Restoration
with Dam
Removal
This subfacility is used by the Dam Safety program for recording stream restoration
activities associated with the removal of jurisdictional and non-jurisdictional dams.
Table Template Example
Subfacility Type
STRDR
Stream Restoration w/ Dam Removal
Id
STRDR01
EXISTING DAM REMOVAL
County
Berks
Municipality
Greenwich
Latitude Degrees
40
Latitude Minutes
33
Latitude Seconds
23
Longitude Degrees
-75
Longitude Minutes
48
Longitude Seconds
26
Dam is Off-Stream
N
Dam Normal Pool Area
Direct Stream Impact
Length
Width
Stream Length Impounded
Avg. Stream Width Impounded
Stream Length Restored
8,000
Avg. Stream Width Restored
16
Field Name and Description
Dam is Off-Stream -
A checkbox indicating whether the non-jurisdictional dam is located off stream. A
‘?’ (yes) indicates that the dam is located off-stream. A blank (no) indicates that the dam is not located
off-stream. The checkbox defaults to null (no).
Normal Pool Area -
The size in acres of the normal pool area. The area must be greater than zero and
in the format 99,999.
Direct Stream Impact: Length -
The length of the stream in feet directly impacted through excavation of
reservoir and/or placement of dam. The length must be greater than zero and in the format 9,999.9.
Subfacility
Authorized Activities/Structures
Code
Name
OTHER Other
Activities
This subfacility must only be used when one of the other subfacility codes does
not adequately cover the activity or structure. A description of the activity and
pertinent data must be entered in the comment field to adequately describe
what is authorized.

3150-PM-BWEW0017
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Instructions
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Table Template Example
Subfacility Type
OTHER
Other Activities
Id
OTHER01
CAUSEWAY
County
Washington
Municipality
North Charleroi
Latitude Degrees
40
Latitude Minutes
22
Latitude Seconds
38
Longitude
Degrees
-78
Longitude Minutes
25
Longitude Seconds
12
Remarks
GP-8 for a causeway is required for this project - for removal of existing spans,
construction of pier and beam seating operations. The causeway will consist of 5
- 4' diameter pipes.
Field Name and Description
Remarks -
The appropriate remarks concerning the SLLA for coordination with CO or for Other activity
authorized an adequate description of what is being authorized. The EDIT ITEM button is available to
enter comments using MS Notepad.

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