20181245 Ver 2_O_M_10_14_20_20201014

Operation & Maintenance Agreement
Project Name:
rerguson Street Develo
Project Location:121 Ferguson Street Sylva, NC 28779
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 & cc
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:
ing O&M sheets wi
Location(s)
Location(s)
Locations)
Locations)
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(:):
Location(:):
Type:
il be added automatically):
As Shown Per Plan
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.
Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Owner, Tinsel Town, Inc.
51 Bridge Street I
IC 28779
.0253
r 1 L� ss��
Signature: 11 Date: / -iy
1, loll le V\Cy } 5 a Notary Public for the State of
County of An do hereby certify that
personally appeared Vefore me this day of �� t�at� and
acknowledge the due execution of the Op rations and Maintenance Agreement.
Witness my hand and official seal,
Seal
My commission expires
NORM-EZ
'ersion 1.5
O&M Agreement
10/14/2020
Page 1 of 1

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Proprietary System Maintenance Requirements
How many devices are
Contech StormFilters?
ATTACH MANUFACTURER'S MAINTENANCE MANUAL FOR ALL PROPRIETARY DEVICES






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















        
        




         





  

       






















         



























     













































 




 





 

 




 






 




 

 





















