SW5210701_Response To Comments_20210818 (3)

Qpera#lon & Maintenance Agreement
Project Name: Beaver Creek Subdivision - Phases 2 & 3
Project Location: Intersection of Claude Lewis Rd & Beaver Dam Rd, Middlesex, NC
Cover Page
Maintenance records shall be kept on the following SCM(s). This maintenance record shall be kept in a log in a known set location.
Any deficient SCM elements noted in the inspection will be corrected, repaired, or replaced immediately. These deficiencies can affect
the integrity of structures, safety of the public, and the pollutant removal efficiency of the SCM(s).
The SCM(s) on this project include (check all that apply & corresponding O&M sheets will bf
Infiltration Basin Quantity:
Infiltration Trench Quantity:
Bioretention Cell Quantity:
Wet Pond Quantity:
Stormwater Wetland Quantity:
Permeable Pavement Quantity:
Sand Filter Quantity:
Rainwater Harvesting Quantity:
Green Roof Quantity:
Level Spreader - Filter Strip Quantity:
Proprietary System Quantity:
Treatment Swale Quantity:
Dry Pond Quantity:
Disconnected Impervious Surface Present:
User Defined SCM Present:
Low Density Present:
0
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Type:
0
0
0
0
0
0
0
0
0
0
0
0
No
No
Yes
Vegetated swales/roadside ditches
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for
each SCM above, and attached O&M tables. I agree to notify NCDEQ of any problems with the system or prior to any changes to the
system or responsible party.
Signature:
County of
Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
R
personally appeared before me this
Little Bear Creek Properties, LLC
Developer
755 Ranch Road
Clayton, NC 27520
919.612.6735
[e-mail]
Date:
a Notary Public for the State of ►\\ljX v V
do hereby certify that car + ,pit
day of �6UjoN�� c� Oa and
acknowledge the due execution of the Operations and Maintenar;ce Agreement .
Witness mZ Iq@ntIleh4gyicial seal,
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My commission expires
STORM-EZ 8/12/2021
Version 1.5 O&M Agreement Page 1 of 1