SW3240102_O&M Agreement/Plan_20240426

uperation & Maintenance Agreement
Project Name: Lanes Creek Volunteer Fire Department
Project Location: 7608 Landsford Road, Monroe, NC 28112
Cover Page
laintenance 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
ffect the integrity of structures, safety of the public, and the pollutant removal efficiency of the SCM(s).
he SCM(s) on this project include (check all that apply & corres onding O&M sheets will be added automatically):
Infiltration Basin Quantity: Location(s): _
Infiltration Trench Quantity: Location(s):
Bioretention Cell Quantity: Location(s):
Wet Pond Quantity: Location(s):
Stormwater Wetland Quantity: Location(s):
Permeable Pavement Quantity: Location(s):
Sand Filter Quantity: Location(s):
Rainwater Harvesting Quantity: Location(s):
Green Roof Quantity: Location(s):
Level Spreader- Filter Strip Quantity: Location(s):
Proprietary System Quantity: Location(s):
Treatment Swale Quantity: Location(s):
Dry Pond Quantity: Location(s):
Disconnected Impervious Surface Present: No Location(s):
User Defined SCM Present: No Location(s):
Low Density Present:F Yes Type:I Dispersed flow only
acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for
ach SCM above, and attached O&M tables. I agree to notify NCDEQ of any problems with the system or prior to any changes to
1e system or responsible party.
Responsible Party: Robert Sweatt
Title & Organization: Lanes Creek Volunteer Fire Department
Street address: 7608 Landsford Road
City, state, zip: Monroe, NC 28112
Phone number(s): 704-361-3047
Email: [e-mail]
Signature: �iZ�yf�'') Date: ( ..
a Notary Public for the State of
rY
county of J-A-k CAL'') do hereby certify that
ersonally appeared before me this ( +`" day of LC (0`4/- + J and
cknowledge the due execution of the Operations and Maintenance Agreement .
Vitness my hand and official seal,
My commission expires
FORM-EZ 10/23/20: