SW4201201_O&M Agreement_20210122

Operation & Maineenance Agreement
Project Name: COLDWATER
Project Location: 8228 Coldwater Road, Stokesdale, 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 & correspor
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:
No
User Defined SCM
Present:
No
Low Density
Present:
Yes
O&M sheets will
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:
J Vegetated swales/roadside ditches f
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 numbe4sl:
Signature:
County of
personally appeared before me this
Paul Hoist
Coldwater Development, LLC
5411 Tory Hill Dr
Greensboro, NC 27410
336-944-7919
paul@1stc inahomes.com
Date: `` f c -
a Notary Public for the State of
�r do hereby certify that
%lD day of and
acknowledge the due execution of the O ratio s and Mainte ance Agreement.
Witness my hand and official seal,
COLE M NERO
Guilt rri County gyros
My
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M commission ex ires
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STORM-EZ 1 /15/2021
Version 1.5 O&M Agreement Page 1 of 1