SW1221001_O&M Agreement/Plan_20221004

O eration & Maintenance Agreement
Project Name: Patton Cove
Project Location: Haywood County
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 & coi
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
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:
)e aaaeo
side of
1 acknowledge and agree by my signature belowthat 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: Ken Jackson
Title & Organization: Agent, Patt
Street address:
City, state, zip.-
• Phone number(s): 828-684-8800
Signature: 7 Date: ).7
I, �Ci , a Notary Public for the State of
County of , do hereby certify that d
personally appeared before me this day ofand
acknowledge the due execution of per s and Maintenance Agreement
Witnes ilhgq�if nd official se Cl►cl
NOT
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� �N9 ,o6 m
9�o"kiC
II imuulr My commission expires
STORM-EZ 9/1412022
Version 1.5 O&M Agreement Page 1 of 1