SW4210401_SIGNED_O&M_20210426

Operation & Maintenance Agreement
Project Name:
Project Location:
Brown Apartments
599 Old US 421 South, Boone, NC 28607
Cover Pa e
Maintenance records shall be kept on the following BMP(s). This maintenance record shall be kept in a log in a known set location.
Any deficient BMP 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 BMP(s).
The BMP(s) on this project include (check all that apply & cc
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Level Spreader/VFS
Quantity:
Permeable Pavement
Quantity:
Proprietary System
Quantity:
Rainwater Harvesting
Quantity:
Sand Filter
Quantity:
Stormwater Wetland
Quantity:
Wet Detention Basin
Quantity:
Disconnected Impervious Area
Present:
User Defined BMP
Present:
nding O&M tables will
Location(s):
Location(s):
Locabon(s):
Location(s):
Location(s):
Location(s):
Locabon(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
be aaaea auram
1 36.229957'.-81.6319100 1
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for
each BMP above, and attached O&M tables. I agree to notify NCDENR 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:
Jason Kent Brown
Owner
230 Hardin Road
Boone, NC 28607
828-964-0514
kentbrown6688 mail.com
Signature: Date: 010�
I, �GS%(ca �'i0wn a Notary Public for the State of �%Oii CAD"D
County of do hearby certify that - Sor }� P�-� '6�-Uct/'�q
personally appeared before me this day of �i'�� 6L t and
acknowledge the due execution of the Operations and Maintenance Agreement.
Witness my,OA90�and official seal, i0.
• �.
J
P,R Y "
m O V z!
P
;, GL co
TA UG A c
STOgbz
Liam My commission expires �/'? / 4/19/2021
Page 1 of 2
Version 1.4