SWA000212_O&M Agreement/Plan_20230706

Permit Number:
(to be provided by DWQ)
StormFilter Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will 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 removal efficiency of the BMP.
Important maintenance procedures:
- The drainage area will be carefully managed to reduce the sediment load to the
StormFilter.
- The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
six inches.
The ADS Stormtech/Bayfilter system will be inspected annually.Records of operation and
maintenance will be kept in a known set location and will be available upon request.
Inspection activities shall be performed as follows.Any problems that are found shall be
repaired immediately.
B11! ele�nnt`,,, ,, l'otenEal xolIem ;- H W ''will rem_ ec) ate the 'a r F `.
Entire BMP Trash/debris is present. . ... �> RemovetbhYern,,.
the trash/debris.
Adjacent pavement(if Sediment is present on the Sweep or vacuum the sediment as soon as
applicable) pavement surface. possible.
Flow diversion structure The structure is clogged. Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged. Make any necessary repairs or replace if
damage is too large for repair.
StormFilter Cartridges Cartridges not performing as Replace cartridges per manufacturer's
designed-see ADS I&M recommendations.
document to determine if
cartridge maintenance is required.
Outlet device Clogging has occurred. Clean out the outlet device.Dispose of
the sediment offsite.
The outlet device is damaged Repair or replace the outlet device.
Receiving water Erosion or other signs of damage Contact the NC Division of Water
have occurred at the outlet. Quality 401 Oversight Unit at 919-733-
1786.

Permit Number:
(10 be provided by DWQ)
All other operation and maintenance activities should be in accordance with ADS's StormTech/
Bayfilter Inspection and Maintenance Procedures document.Any problems that are found shall be
repaired immediately.I acknowledge and agree by my signature below that I am responsible for the
• performance of the maintenance procedures listed above and have received and understand ADS's
StormTech/Bayfilter Inspection and Maintenance Procedures document. I agree to notify DWQ of
any problems with the system or prior to any changes to the system or responsible party.
Project name:Courtyard Marriott at Village of Sugar Mountain
BMP drainage area number:#1 (Hotel ADS Stormtech/Bayfilter)
Print name:John Reece(Sugar Mountain Hospitality,LLC)
Title:Manager
Address:751 West Four• ...8ti . Wi o -Salem,NC 27101
Phone:[phone]
Signature: Z. -Iv _
Date: d'u.r C . b , U j 3
Note: The legally responsible party should not be a homeowners association unless more than 50%of the lots
have been f So &biw9
old and a resident of the subdivision has been named the president. �
I, kvh41 ,a Notary Public for the State of /U®1411 etc f11
County of f(3 , do hereby certify that .... hn E. Rcct, (�
personally appeared before me this 36 day of Mara) , and acknowledge the due
execution of the forgoing stormwater system maintenance requirements. Witt ss my hand d of icial seal,
KRISTIN SALISBURY
Notary Public, North Carolina
. :•'y� `r� Forsyth County
t4v4iz,v My Commission Expires
October 28,2023
YM' fp�n6iwPlin i
SEAL
My commission expires I b/ 2157

• Permit Number:
(to be provided by DWQ)
• StormFilter Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will 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 removal efficiency of the BMP.
Important maintenance procedures:
• — The drainage area will be carefully managed to reduce the sediment load to the
• StormFilter.
— The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
six inches.
The ADS Stormtech/Bayfilter system will be inspected annually. Records of operation and
maintenance will be kept in a known set location and will be available upon request.
Inspection activities shall be performed as follows.Any problems that are found shall be
repaired immediately.
B1VII'elem'"ritt` —� Tom-
.... �, +....,. :,, .. ,: . ',. .. ::nolenlxal pro$lem. ..:: . , . . . ,,:•.. . ...,.;� How I willem�dia#e the:, �bblem� � a �,,:�:
Entire BMP Trash/debris is present. Remove the trash/debris.
Adjacent pavement(if Sediment is present on the Sweep or vacuum the sediment as soon as
applicable) pavement surface. possible.
Flow diversion structure , The structure is clogged. Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged. Make any necessary repairs or replace if
damage is too large for repair.
Storinfilter Cartridges Cartridges not performing as Replace cartridges per manufacturer's
designed-see ADS I&M recommendations.
document to determine if
cartridge maintenance is required.
Outlet device Clogging has occurred. Clean out the outlet device.Dispose of
the sediment offsite.
The outlet device is damaged Repair or replace the outlet device.
Receiving water Erosion or other signs of damage Contact the NC Division of Water
have occurred at the outlet. Quality 401 Oversight Unit at 919-733-
1786.

Permit Number:
(to be provided by DWQ)
All other operation and maintenance activities should be in accordance with ADS's StormTech/
Bayfilter Inspection and Maintenance Procedures document.Any problems that are found shall be
repaired immediately. I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above and have received and understand ADS's
StormTech/Bayfilter Inspection and Maintenance Procedures document. I agree to notify DWQ of
any problems with the system or prior to any changes to the system or responsible party.
Project name:Courtyard Marriott at Village of Sugar Mountain
BMP drainage area number:#2(Additional Parking Lot ADS Stormtech/Bayfilter)
Print name:John Reece(Sugar Mountain Hospitality,LLC)
Title:Manager
Address:751 West Fourth Street, Winston-Salem,NC 27101
Phone:[phone]
Signature: f
Date: / is - 3 / ?6.e) 3
Note: The lega y responsible party should not be a homeowners association unless more than 50%of the lots
have been sold and a resident of the subdivision has been named the president. ,l�, Oiø
eriS)r�Sc.11sbv'� a Notary Public for the State of fd (/ J bi
County of Yc5TO) , do hereby certify that John 6, Q cC e
personally appeared before me this ��IIJ�`' day of TY)2y,}, , ZQz3>and acknowledge the due
execution of the forgoing stormwater system maintenance requirements. it ess my hand d official seal,
KRISTIN SALISBURY
y 1 ; Notary Public, North Carolina
Forsyth County
'4114 1 My Commission Expires
October 28,2023
SEAL
My commission expires a01 Zg)20Z3