SW3201001_O & M_Granite Quarry_20210217

Operation & Maintenance Agreement
Project Name:
Project Location:
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).
Dollar General Store #22446
US Hwy 52 - Granite Quarry, NC
The SCM(s) on this project include (check all that apply & co
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 will
Location(s):
Location(s):
Location(s):
Locatioll
Location(s):
Location(s):
Locatiorl
Location(s):
Location(s):
Locatiorl
Location(s):
Locatioll
Location(s):
Location(s):
Location(s):
Type:
added
I acknowledge and agree by my signature below that 1 am responsible for the performance of the maintenance procedures listed for
each SCM above, and attached 0&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:
Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Wail:
Joe Strickland
NC Director of Operations, Teramore Development, Ll_C.
214 Klumac Road, Suite 101
Salisbury, NC 28144
704.224.7364
[e-mail]
p4- 4L-11.4 29n1 , a Notary Public for the State of
County of & o WA/,/ _._ , do hereby certify that
personally appeared before me this T day of 0 GT 0 B E/1 and
acknowledge the due execution of the Opera' and aintenan Agreement .
Witness my hand and official seal,
Date: %- S- 076a6
Seal
R AL VkZAN
W".,ARY PU 3LIC
,rowan COL rity
North Carol na
I Expill ,tune 25, 2022
s0 I~
My commission expires Z UN C- 2 57 / 2 0 2- 2
STORM-ez
Version 1.6
Q&M Agreement
9/2sr2020
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