N-0040-11 SCM Inspection_4.4.2022

City of Raleigh Engineering Services
Stormwater SCM Internal Inspection
Bioretention
Stormwater Inspections Form 601
Page 1 of 2
Rev ϰ, :ĂŶ 201ϵ
Project Name:Permit Number:Anniversary Date:
Property Owner:Device Number/Location:
Date of Inspection:Inspector:Overall Status
Important Note: It shall be noted that the items included in this inspection checklist are not an exhaustive list of inspection items for any particular
facility, or this list shall count as the facilities annual inspection. As each facility is different, the City looks to the professional inspecting the facility
to perform a comprehensive inspection of the facility and list all items found during the inspection.
Checklist Status Codes
Fully Functional All parts are in good working order (FF)
Minor Functional Issues Device is functional, but has some minor areas to monitor (MFI)
Partially Functional Part of the device needs repairs (PF)
Not Functional Repairs are required (NF)
Notes:
1.Minor Functional Issues shall be monitored throughout the year, and resolved if conditions worsen
2. Partially Functional and Not Functional items will be reported to the owner, to be corrected prior to the annual inspection
Assessment Comments
INFLOW POINTS STATUS: FF MFI PF NF
x Obstructions
x Erosion/undercutting
x Overall Structural Condition
x Displacement/blockage of inlet or
rip-rap, aprons, fabric, etc.
x Pipe Condition
x Other
PERIMETER/SIDE SLOPES/
EMBANKMENT
STATUS:FF MFI PF NF
x Sediment/debris accumulation
x Bare soil/ erosion on side slopes
x Woody vegetation
x Invasive vegetation
x Side Slope maintained/mowed
x Other
PRE-TREATMENT AREA (FOREBAY,
GRASS SWALE/ VERGES, & GRAVEL)
STATUS: FF MFI PF NF
x Sediment/debris accumulation
x Erosion/gullies present
x Invasive vegetation
x Flow bypassing pretreatment
x Other
Hampton Inn
RALGIC LLC 1 Bioretention
"Kill rings" within/around inlet dissipaters indicates herbicide use,
which should stop. Herbicides should not be used in and around
devices, unwanted vegetation should be addressed by hand or with
machinery instead.
Regularly remove leaf/debris accumulation from inlet channels and
dissipater.
Address and fill-in cavity/hole in the top of the embankment closest to the
riser structure, ensure cause is not structural, or an evacuation of soil.
(there are no drainage pipes below the hole, appears to of been dug out).
Monitor areas of bare groundcover and supplement as needed with
routine maintenance.
N/A
4/4/2022
12/20
MFI
N-0040-11
✔
✔
✔
Clear Form
Laura Johnson
M I MFI
MFI
City of Raleigh Engineering Services
Stormwater SCM Internal Inspection
Bioretention
Stormwater Inspections Form 601
Page 2 of 2
Rev ϰ, JĂŶ 201ϵ
Assessment Comments
BIORETENTION CELL STATUS: FF MFI PF NF
x Overgrown vegetation
x Plantings/required vegetation
x Mulch is decomposed or displaced
x Soils/ mulch clogged with sediment
x Ponding duration/proper
infiltration
x Bare or eroded areas in grass cells
OUTLET DEVICE STATUS: FF MFI PF NF
x Obstructed pipe
x Erosion/undercutting
x Joint failure/loss of joint material,
soil piping
x Overall structural condition
x Sediment in pipe
x Displacement/blockage of outlet or
rip-rap, aprons, fabric, etc.
x Underdrains
x Other
MISCELLANEOUS STATUS: FF MFI PF NF
x Trash/debris
x Access
x Evidence of routine maintenance
PHOTOGRAPHS: Include caption describing the photographs below.
Photo 1:Photo 2:
Overall groundcover is healthy and stable. Monitor bare spots
throughout (looks like areas that may have been sprayed). Make
sure herbicides are not being used in/around devices. Remove
unwanted/weedy vegetation by hand or machinery only.
Minor leaf debris accumulation in riser, monitor and address as
needed. Device outlets to the ROW storm system, does not
daylight.
Overall site (hotel parking lot and grounds) appear stable, clean
and regularly maintained.
Device Overview Primary Inlet. Some bare areas on embankments.
Minor leaf/debris accumulation in dissipater.
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MFI
M I MFI
F FFF
City of Raleigh Engineering Services
Stormwater SCM Internal Inspection
ADDITIONAL PHOTOGRAPHS:Include caption describing the photographs below.
Unobstructed Secondary Inlet, "kill rings" around
dissipater visible. Some bare areas are visible
around underdrain cleanout.
Interior of riser, minor leaf debris accumulation.
Hole on top of embankment, next to riser.
Clear Form
Seal redacted in
accordance with
N.C. General Statutes,
Chapter 132
Copy of as-built
survey/plan for reference.
Seal redacted in
accordance with
N.C. General Statutes,
Chapter 132
PO Box 590
One Exchange Plaza
Raleigh, NC 27602
Form-501 Phone [phone]
v1.2020 www.raleighnc.gov
Form-501
Stormwater Device
Annual Inspection Report Summary
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Project Name N-File 1
Project Address
City State Zip
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Property Owner/Contacts Name Email Phone
Property Owner/Contacts Address City State Zip
Recorded BK BM PG of lot for all required device(s)
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Additional pages are necessary to complete the stormwater device annual inspection report. The following items are to
be included for each stormwater device;initial by each item as indication of inclusion:
BBBB 1DUUDWLYHRIJHQHUDOVLWHFRQGLWLRQ
BBBB 'HYLFH7\SH&LUFOH'HYLFHV:HW3RQG'U\3RQG:HWODQG%LRUHWHQWLRQ8*'HWHQWLRQ6DQG)LOWHU:4
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BBBB 'LVFORVXUHRIFRPSOHWHGUHSDLUV
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BBBB 3KRWRJUDSKVRILQVSHFWHGVWRUPZDWHUGHYLFHV
BBBB $OOLWHPVIURPWKHStormwater Device Annual Inspection ChecklistUHYLHZHGDQGDGGUHVVHGLQUHSRUW
*Reports must be submitted in electronic form. All the above items must be included, and the report emailed to
[e-mail] as a VLQJOH PDF attachment. Confirmation will be sent out within 5 days of receipt. If there is no
response by the 5th day, please contact SCM Staff to make sure the report was received.
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I,BBBBBBBBBBBBBBBBBBBB, as a duly registered BBBBBBBBBBBBBBBBBB in the State of North Carolina attest that on
BBBBBBBBBBBBBBB,20BBBBB a thorough inspection was conducted of this site to ensure all required stormwater control facilities
including open space areas are performing properly and are in compliance with the approved stormwater control plan, the
applicable maintenance manual required by Unified Development Ordinance (UDO) Sect 9.2.2(D) and the Raleigh Stormwater
Control and Watercourse Buffer Manual. No sampling of pollutant loading is required as part of the inspection. All information
provided is correct to the best of my knowledge. It is a violation of UDO 9.2.5(F) to falsify this certification. A civil penalty for
falsifying this certification shall be assessed by the City of Raleigh in the amount of $3,000.00.
Certifier's Name License Number Place Seal Here
Title Company Name Email
Address City State Zip
Signature Date Telephone
$QQXDO,QVSHFWLRQ5HSRUWV3HU8QLILHG'HYHORSPHQW2UGLQDQFH+DQRULJLQDOLQVSHFWLRQUHSRUWRIDOOUHTXLUHGVWRUPZDWHU
FRQWUROIDFLOLWLHVLQFOXGLQJRSHQVSDFHDUHDVVKDOOEHILOHGZLWKWKH&LW\GXHHDFK\HDURQWKHDQQLYHUVDU\RIWKHDVEXLOWFHUWLILFDWLRQ
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For City Staff Use:
Date Received:
Date Accepted:
By:
Next Report Due:
11/16/2021
12/9/2021
DH
12/20/2022
Hampton Inn - Crabtree
0040-11
3920 Arrow Drive
Raleigh
RALGIC LLC
4131 PARKLAKE AVE STE 360
Book: 014421 Page: 00866
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Timothy P. Grady
President
P.O. Box 297
North Carolina 27612
[e-mail] 919-468-9190
RaleighNC 27612
Timothy P. Grady Landscape Architect
November 3 21
1015
G2 Design, [e-mail]
Apex NC 27502
11/16/2021 919-321-0638
Seal redacted in
accordance with
N.C. General Statutes,
Chapter 132
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G2
Stormwater Services
D esign
P: 919.321.0638
F: 919.321.8311

PO BOX 297
Apex, NC 27502

67250:$7(56&0,163(&7,215(3257
IInspection Date: 11. 03. 21





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Project Name:HHampton Inn Crabtree SCM Quantity/Type: 11 Bioretention Basin
Location: 33920 Arrow Drive
Raleigh,, NC
Coordinates of SCM(s): 335° 50’ 09.04”” NN
778° 40’ 24.90” W

Narrative of SCM/ General Site Conditions:TThe site is
developed as a hotel and support parking. The
stormwater runoff is captured and treated by one
bbioretention basin located near the south west corner of
the property which discharges into the storm sewer. The
ccontributory watershed is stable and the SCM is
functiioning as intended.
Disclosure of Completed Repairs:RRemoved sediment
ffrom the concrete inlet flume; applied pine straw to bare
aareas on the flank of the inlet



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& $GGLWLRQDO&RPPHQWV5HFRPPHQGDWLRQVOwner shall advise landscape contractor to maintain basin free of
leaves and debris and seed sparse/bare areas in basin in spring and/or fall at the optimal time of year
to maintain turfgrass cover.

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PPHOTOGRAPHS:

A: VIEW OF BIORETENTION BASIN

B: VIEW OF INLET FLUMES & DISSIPATERS

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C: VIEWS OF RISER OUTLET STRUCTURE

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D: VIEW OF STABLE SIDE SLOPES

-END OF REPORT-
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Please review the following checklist prior to submitting your stormwater device annual
inspection report. The checklist will help you identify items that should be included in the annual
inspection report. If you are missing an item, the report may get denied. Additional information
may be requested by staff. Contact us with questions at [e-mail].
Initial
Below
___ a. The report is being submitted within 30 days of the date the actual inspection took place.
___ b. The report is being submitted no more than GD\VSULRUWRWKHVLWH¶VDQQLYHUVDU\GDWH
___c. The report is completed and sealed by a North Carolina professional engineer, surveyor,
or landscape architect.
___ d. A completed Form-501 is the cover-page of the report.
___ Section-A clearly identifies the site name, N-file number, and site/project address.
___ Section-B lists the best contact information for the property owner/representative
or responsible party, if different from the tax record listed property owner.
___ Section-C identifies each device type that was inspected (if multiple).
___ Section-D lists the date the actual inspection occurred within the certification
statement paragraph. (The date that the report was sealed should go next the
certifiers signature and/or over their seal).
___ e. All devices in the report are referenced by the name/identifier used in the original
stormwater management plans for the site.
___f. If there are multiple devices in a report, the information and photos for each device are
clearly separated and labeled.
___g. The report includes a brief summary of site/device history, and current condition (i.e.
recent weather, maintenance level, minor issues, deviation from approved plans, etc..).
___h. Any repairs made over the past year are noted in the report, with descriptions of what
work was completed and when. Before and after photos are recommended but not
required.
___i. If needed routine maintenance items or repairs are noted in the report, enough detail is
provided so a property owner or maintenance staff can identify and address it. (i.e.
include instructions on how and when the item should be addressed)
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___j. All photos are high resolution, color images at a visible scale with captions that clearly
describe what the photo is depicting.
___1. Inspection photos that must be included in report (if present in device);
___ Main Treatment Area Overview ___ Device Embankments
___ Emergency Spillway ___ Earthen Berms/Weirs
___ Forebays ___ Interior of Inlet Piping
___ Inlet FES & Dissipators ___ Unobstructed Orifice(s)
___ Inside & Outside Riser Structure ___ Cleanouts/Underdrains
___ Interior of Outlet Piping ___ Outlet FES & Dissipators
___2. Reports with underground devices must include photos taken inside the device
(confined space certification may be needed). Photos that must be included in the
report (if present);
___ Overview of Contributory Site ___ Inlet Structures (Inside & Out)
___ Unobstructed Orifice(s) ___ Weir Walls
___ Interior of Detention Piping ___ Sediment/Sand Chambers
___ Interior of Outlet Piping ___Outlet Discharge Area
___k. The report is a single PDF document and submitted as an email attachment to
[e-mail].
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Seal redacted in
accordance with
N.C. General Statutes,
Chapter 132
STORM WATER GRASS BIO RETENTION FILTER SYSTEM
OPERATIONS AND MAINTENACE MANUAL
SECTION I- INTRODUCTION:
This manual establishes procedures for maintenance and operation of stormwater in accordance
with the guidelines as set forth in the City of Raleigh's Stormwater Management Design Manual.
The City ordinances require that stormwater devices be inspected aiulually and that they be
maintained in accordance with this document. Any repairs that become necessary as a result of
periodic inspections shall be completed within thirty (30) calendar days of filing the report unless
written approval of and extension is obtained from the City of Raleigh Engineering or
Conservation.
A. Permanent Stormwater Detention Device
This development plan includes the construction of one (1) open basin bio retention filter system
to remove Nitrogen from the runoff of a small area of the parking lot upstream from the bio
retention area. The runoff enters the bio retention area through 2 concrete flumes labeled FL
41 Oa and FL 41 Ob on the construction drawings referenced below.
The location of the bio retention area is at the northwest portion of the property. Access to the
bio retention area system is via Private Drainage Easements. Access limitations do not prevent
major maintenance of this small Bio retention area system.
The bio retention area was installed to remove nitrogen from the runoff only. The system was
not needed to control runoff of the 2, 10 and 100-year storm events. The storm water that
accumulates in the bio retention area will release water until the bio retention area is
completely drained. The system should empty in a 7-8-hour period, thru the bio retention area
and Jim ugh outlet structure (YI #10).
For additional data on the detention system consult construction drawings prepared by Aiken &
Yelle Associates, PA entitled "HAMPTON INN AT CRABTREE." 3920 Arrow Dive. Raleigh,
North Carolina" dated 8-15-11 and further approved by the City of Raleigh Engineering Division
on
Please note that the bio retention area must be inspected annually within two weeks plus or
minus of this date by an individual certified to inspect detention systems by the State of North
Carolina
The Bio retention area
This bio retention area is located in the northwest portion rear of the property. The open
basin bio retention area (40'(1) x 18'(w) x V(d)) contains a runoff volume of approximately
700 cubic feet. The bio retention area consists of a graded area like a bowl designed to hold
a maximum of 1 feet (depth) of storm runoff. The runoff is filtered through 30 inches of
Page 2 of 10

sandy type media to remove Total nitrogen content from the runoff. The runoff is emptied
via a 4" perforated drain at the bottom of the bio area to an outlet pipe in YI410. Storm
runoff in excess of the storage capacity will exit the Bio retention area through the weirs in
YI410.
The design of the Grass Bio retention area was dictated by the North Carolina DENR
Stormwater BMP Manual. Dated 9-09
SECTION II- BIO RETENTION AREA DEVICE MAINTENANCE
A. Erosion
Erosion occurs when the water concentrates causing failure of the vegetation or when
vegetation dies and sets up the envirorunent for rill erosion and eventually gullies from the
stormwater runoff. The area adjacent to FL #10a and FL#10b, should be inspected for signs
of erosion. Proper care of vegetative areas that develop erosion is required to prevent more
serious damage to bio retention area and down stream areas. Eroded areas should be filled
with suitable soil compacted then seeded. Methods described in Section II -A should be used
to properly establish the grass surface. Where eroded areas are observed, the cause of erosion
should be addressed to prevent a continued maintenance problem. This can be corrected by
reshaping to more evenly distribute the runoff to areas that are not experiencing erosion
problems.
B. Seepage Detection
Due to the nature of the detention device, noticeable seepage should not be expected from this
facility. However, a cursory inspection of the bio retention area area and downstream area should
be made for completeness of the inspection. Seepage may vary in appearance from a soft wet
area to a flowing spring. It may show up first as only an area where the vegetation is lush and
darker green often become established in a seepage area. The down stream areas where the
embankment fill and natural ground interface are very common locations for seepage. Also the
natural ground interfaces are very common locations for seepage. Seepage of this type is
generally attributed to poor compaction around the pipe and is generally most evident on the
underside of the pipe. .
Page 3 of 10

C. Settlement
Settlement occurs both during construction and after the bio retention area device has been
completed and places in service. To a certain degree this is normal and should be experienced. It
is usually the most pronounced at the location of maximum foundation depth or embankment
height. A relatively large amount of settlement (more than 3") within a small area could indicate
serious problems in the device. This should be addressed immediately. Settlement accompanied
by cracking often precedes failure. If any of the above items are detected there may be signs of
significant problems, which could lead, to the failure of the structure. A geotechnical or civil
engineer should be consulted regarding the origin of these problems and for the assessment of
the appropriate solutions for correcting them
III. MAINTENANCE OF CONDUITS & CONTROL STRUCTURES
A. Inspection of Conduits
Conduits should be inspected thoroughly once a year. Conduits should be visually inspected
at the joints. Pipes should be inspected for proper alignment (sagging), elongation and
displacement at joints, cracks, leaks, surface water, surface wear, loss of protective coating,
corrosion and blocking. Problems with pipes most often occurs at joints and special attention
should be given to them during inspection. Joints should be checked for gaps caused by
elongation or settlement and loss of joint filler material. Open joints can permit erosion of the
embankment material and possibly the piping of soil material through the joints. Catch basin
should be checked for signs that water is seeping along the exterior surface of the pipe where
it enters the catch basin. A depression in the soil surface over the pipe may be signs that soil
is being removed from around the pipe. ♦ If problems are detected: Retain the assistance of a
civil engineer or geotechnical engineer qualified in the design bio retention area/ detention
systems.
IV. OPERATION
A. Trash Control
It is important to control the potential risk of system blockage due to the presence of trash such
as cardboard, bottles, trash bags, etc. in the piping and outlet structure. Due to the nature of the
flow -control structure, trash or other items could possibly become trapped in the structure and
cause partial or complete blockage. Site maintenance should include routine and effective trash
collection and control measures.
Page 4 of 10

B. Sediment Removal
Sedimentation from areas tributary to the site will result in the reduction of the storage volume
in the fore bay area. Sediment deposited in the system will require removal. The frequency of
the sediment removal can be reduced by ensuring that the site areas around the building are
stabilized with a vegetative ground cover such that it restrains erosion. This requires periodic
reseeding and Iimited applications of fertilizer and other treatments necessary to promote a
stable groundcover and minimize sedimentation. When the sediment level at any point within
the forebay or outlet structure exceeds 4 inches in depth, the sediment must be removed and the
original volume restored. Generally, the removal process should be carried out by methods that
do not simply wash the sediment downstream. If scouring and flushing is used, filtering or
trapping devices should be installed immediately below the piping to capture sediment for
removal. It is very important to remove sedimentation from the pipes regularly and prior to any
large accumulation, as the degree of removal difficulty, and the likelihood of down stream
impacts increase significantly with increased sediment depth and volume.
C. Record Keeping
Operation of the bio retention area system should include recording of the following:
Annual Inspection Reports — a collection of written inspection report should be kept on record
in Section IV of this manual. Inspection should be conducted annually. Copies should be
provided to the City of Raleigh Stormwatcr Management Section of the Engineering Division.
Observations — all observations should be recorded. Where periodic inspections are performed
following significant rainfall events, these inspections should be logged into the Periodic
Inspection, Operation & Maintenance Form in Section V of this manual.
Maintenance — written records of maintenance and/or repairs should be recorded on the Periodic
Inspection, Operation & Maintenance Form in Section IV of this manual.
Other Operation Procedures — the owner should maintain a complete and up-to-date set of
plans (as -built drawings approved by the City of Raleigh). All changes made over time should
receive prior approval by the City of Raleigh and be reflected on the as built drawings.. Any
resulting changes to the replacement cost made necessary by these modifications shall be listed
as items covered by the escrow with all amounts amended accordingly.
Page 5 of 10

V. INSPECTION, OPERATION & MAINTENANCE CHECKLISTS
Date: Time:
(Project Name):
INSPECTION CHECKLIST
Bio retention area/ Detention System #
SPILLWAYS — DRAINS — CONDUITS — OUTLETS
Check
action
completed
Item
Inspected date Observations Repair Monitor Investigate
General Comments, Sketches & Field Measurements
Provide complete and specific itemized list of materials, labor, earthwork and all
associated costs.
Page 6 of 10

SECTION VI: BUDGET
Annual Budget- Open Basin Bio retention area
Annual Inspection & Report
Registered Engineer r
$
350.00
Miscellaneous Visits
$
200.00
Trash removal (Yearly)
$
100.00
Sediment cost removal (every 5 years) annualized cost
$
100.00
Rip Rap Replenishment (every 5 years) annualized cost
$
100.00
I million dollar liability insurance policy
$
250.00
Annual budget for sand replacement (5years)
$
140.00
Total Annual Budget
$
1,240.00
1. Sinking Fund Budget
A. Estimated Construction Cost Open Basin Bio retention
area:
Earth Dam 100 CY
@
$
10.00
$ 1 000.00
4" pvc underdrain 40 LF
@
$
6.00
$ 240.00
4" pvc clean out 2 LF
@
$
32.00
$ 64.00
45' -4" pvc elbow 0 EA
@
$
50.00
$ -
Replacennent sand media 62 CY
@
$
50.00
$ 3 100.00
Spillway Stabilization 0 EA
@
$
200.00
$ -
blanket 85 SY
@
$
3.00
$ 255.00
Rip Rap Pad 0.5 TON
@
$
500.00
$ 250.00
Level Spreader 0 EA
cr
$
300.00
$ -
Seedu1g 0.1 AC
@
$ 2
700.00
$ 270.00
Total Replacement Account Detention system
S 5 179.00
Note; Replacement Contribution Developer contribution payment is due immediately to create
replacement account. A payment of $1,242.96 is to be paid to the City of Raleigh (24% of
$5,179.00)
Page 7 of 10

MAINTENANCE AGREEMENT
Project: Hampton Inn at Crabtree
Responsible Party: Ralgic, LLCI
Address: 2803 Slater Road Suite 115
Morrisville, North Carolina 27560
Monthly Inspection -
A. Visual inspection for signs of erosion after a 1.5-inch or more rainfall event over a
24-hour period to determine if any appreciable damage occurred which would require
repair to the stonnwater device.
B. Remove thrash and debris from basin inlets and outlets and rip rap areas.
II. Quarterly Inspections and Maintenance:
A. Same as the monthly described above.
B. Pipe inspected to ascertain that water would flow out at a proper rate, that there are no
obstructions and that there is no appreciable build-up of silt.
C. Check Sediment level within basins.
III. Semi -Annually and Maintenance:
A. Same as quarterly inspection
IV. Annual Inspection and Maintenance:
A. Same as quarterly and semi-annual inspections.
B. Registered Engineer inspects and confirms that the stormwater device is operating
properly and is in good physical condition. The inspection report shall be in
accordance with Raleigh City Code Section 10-9028. A copy of the inspection reports
in Section V of this manual shall be submitted to the Central Engineering Department
of the City of Raleigh. The date set as a deadline to perform this annual inspection is
one year after the date the as -built drawings were first certified to the City of Raleigh
in accordance with Section 10-9025 of the Raleigh City Code.
C. Sediment shall be removed if it is impeding the water flow.
V. General Maintenance:
A. All components of the bio retention basin system will be kept in good working order.
B. In case the ownership of the basins transfers, the current owner shall within thirty
(30) days of transfer of ownership, notify the City of Raleigh Engineering
Department, Stormwater Management Division of such ownership transfer.
C. This property and stormwater control measures are also subject to the Stormwater
Operation and Maintenance Manual and budget filed relative to this project.
D. Sediment shall be removed from the detention system and riprap shall be replenished
every five years.
VI. Major Maintenance and System Reconstruction.
A. In the event that the Bio retention area System requires major
maintenance the contractor hired to repair must be aware that vehicular
access is not available to the Bio retention area area via vehicle access
Page 8 of 10

I,
pathway. There is a ladder provided on the face of the retaining wall for
man access for general and light maintenance
B. In the event that machinery is needed for excavation within the bio
retention area system the size of the system will not require large
excavation equipment. The recommended machinery needed for
excavation maintenance include a long reach back hoe that can access
most areas of the bio retention area system from the parking area and a
mini excavator or Bobcat mini loader for the areas that can not be
reached by the long reach backhoe. The contractor will be required to
lower the mini excavator or Bobcat mini loader into the bio retention
area area for access.
C. All reconstruction of the Bio retention area System shall be in
accordance with the approved site construction plans prepared by Aiken
& Yelle Associates, PA entitled HAMPTON INN AT CRABTREE."
3920 Arrow Dive. Raleigh, North Carolina" dated 8-15-11 and
further approved by the City of Raleigh Engineering Division on
hereby
acknowledge that I, or my assigns, are the financially responsible party for maintenance of
this bio retention area/ detention system. I will perform the maintenance as outlined in this
document. Furthermore I am aware of the limited access to the bio retention area/ detention
system and I have accepted the limited access as a condition of the maintenance
requirements.
for
I accept this condition of the storm water system maintenance agreement.
Signature:
Company/Partnership:
Date:
a Notary Public for the State of , County of
do hereby certify that personally appeared
before me this day of , 20, and acknowledge the due execution of the
foregoing instrument.
Witness my hand and official seal,
(SEAL)
My commission expires
Notary
Page 9 of I0

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