ENG XXXX Dry Land Approved Jurisdictional Determination Form

U.S. ARMY CORPS OF ENGINEERS (USACE) Form Approved

The proponent agency is CECW-CO-R OMB No. 0710-xxxx

Expires: xx-xx-xxxx

DRY LAND APPROVED JURISDICTIONAL DETERMINATION FORM¹

The public reporting burden for this collection of information, OMB Control Number 0710-xxxx, is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR REQUEST TO THE ABOVE EMAIL.

This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.

SECTION I: BACKGROUND INFORMATION

A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD): Click here to enter a date.

B. DISTRICT OFFICE, FILE NAME, AND NUMBER: File Name & Number

C. PROJECT LOCATION AND BACKGROUND INFORMATION: 

State: County/parish/borough: Click here to enter text. City: Click here to enter text.

Center coordinates of site (lat/long in degree decimal format): Lat. Click here to enter text. °, Long. Click here to enter text. °

Universal Transverse Mercator: Click here to enter text.

Name of nearest waterbody: Click here to enter text.

Name of watershed or Hydrologic Unit Code (HUC): Click here to enter text.

	Check if map/diagram of review area is available upon request.
	Check if other sites (e.g., offsite mitigation sites, disposal sites, etc…) are associated with this action and are recorded on a different JD form.

D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):

	Office (Desk) Determination. Date:		Click here to enter a date.
	Field Determination. Date(s):	Click here to enter a date.

SECTION II: SUMMARY OF FINDINGS

A. RHA SECTION 10 DETERMINATION OF JURISDICTION.

There “navigable waters of the U.S.” within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the review area.

B. CWA SECTION 404 DETERMINATION OF JURISDICTION.

There “waters of the U.S.” within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area.

SECTION III: DATA SOURCES.

A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked and requested, appropriately reference sources below):

	Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant: Click here to enter text.
	Data sheets prepared/submitted by or on behalf of the applicant/consultant.
		Office concurs with data sheets/delineation report.
		Office does not concur with data sheets/delineation report.
	Data sheets prepared by the Corps: Click here to enter text.
	U.S. Geological Survey Hydrologic Atlas: Click here to enter text.
		USGS NHD data.
		USGS 8 and 12 digit HUC maps.
	U.S. Geological Survey map(s). Cite scale & quad name: Click here to enter text.
	USDA Natural Resources Conservation Service Soil Survey. Citation: Click here to enter text.
	National wetlands inventory map(s). Cite name: Click here to enter text.
	State/Local wetland inventory map(s): Click here to enter text.
	FEMA/FIRM maps: Click here to enter text.
	100-year Floodplain Elevation is: Click here to enter text. (National Geodectic Vertical Datum of 1929)
	Photographs:			Aerial (Name & Date): Click here to enter text.
	or			Other (Name & Date): Click here to enter text.
	Previous determination(s). File no. and date of response letter: Click here to enter text.
	Applicable/supporting case law: Click here to enter text.
	Applicable/supporting scientific literature: Click here to enter text.
	Other information (please specify): Click here to enter text.

B. REQUIRED ADDITIONAL COMMENTS TO SUPPORT JD. EXPLAIN RATIONALE FOR DETERMINATION THAT THE REVIEW AREA ONLY INCLUDES DRY LAND: Click here to enter text.

1 This form is for use only in recording approved JDs involving dry land. It extracts the relevant elements of the longer approved JD form in use since 2007 for aquatic areas and adds no new fields.

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