HomeMy WebLinkAbout20120157 Ver 1_Other Agency Comments_20120405OPERATION
I acknowledge and agree by my initials below that the North Carolina Departmem of Transportation is responsible for the
implementation Of the four maintenance items listed_ 1 agree to notify DWQ of any operational problems with the BMP's
that would impact water quality or prior to making any changes to the system or responsible party,
.(at nonce Engineer's Initials
a. BMP's shall be inspected and m i*tai=d is good working order.
b. Erased areas shall be repaired and reseeded as needed.
C. Stormwater collection systems, including piping, inlets, and outlets, shall be maintained to insure proper
functioning.
Diaintenance Engineer's
TV, APPLICATION CERTIFICATION
I, (Print or type name) J 2 rr 4 f -i . Pat r Ke r' of c o crT ! Branch;
certify that the information
On t ucW include on th's permit application form is, to the best of my knowledge, correct and that the
project will be constrttcted in CO de
with the approved plans and that the proposed project complies with the
requirements of 15A NCAC 2H. 1000.
Dn
Address:
V, SUPPLEMENT FORMS
SU�C.fvt v,r
"7 r2�✓t5t!i�+� AIC
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each 1W
specified for this project. Contact the Stormwater and General Permits Unit at (919) 733 -5083 for the status and
availability of these farms.
Form SW401 -Low Density
Form SW401 -Curb outlet System
Form SW401- OffSiie System
FOrnt 5W401 -Wet Detention Basin
Form SW401- hift1tration Basin
Form SW401- Infiltraion Trench
Form SW401- Biaretmum Cell
Form SW401 -Level Spreader
Form SW401- Wetland
Form SW401- Grassed Swale
Form SW401 -Sand Filter
TOO 6tZ'ON
Low Density Supplement
Curb Outlet System Supplement
Off -Site System Supplement
Wet Detention basin Supplement
Infiltration Basin Supplement
Underground bturatton Trench Supplement
Bioretentim, Cell Supplement
Level Spreader /Filter Strip /Restored Riparian Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement
LZ :ST ZTOZ /ST /ZO