SWA000222_Supplement-EZ Form_20240926

I V r r LLI•I LI\ I % V V I I' r AV L.
LOAD SUPPLEMENT FORMS
tOJECT INFORMATION
1 Project Name Compton Addy -Popeyes-Spout Springs,NC
2 Project Area(ac) 0.96
3 Coastal Wetland Area(ac) 0
4 Surface Water Area(ac) 0.18
5 Is this project High or Low Density? Low
6 Does this project use an off-site SCM? No
)MPLIANCE WITH 02H.1003(4)
7 Width of vegetated setbacks provided(feet) 10
8 Will the vegetated setback remain vegetated? Yes
9 If BUA is proposed in the setback,does it meet NCAC 02H.1003(4)(c-d)? N/A
0 Is streambank stabilization proposed on this project? No
AMBER AND TYPE OF SCMs:
1 Infiltration System i 0
2 Bioretention Cell I 0
3 Wet Pond 0
4 Stormwater Wetland I 0 _
5 Permeable Pavement 0
6 I Sand Filter 1
7 I Rainwater Harvesting(RWH) 0
8 Green Roof 0
9 Level Spreader-Filter Strip(LS-FS) 0
'0 Disconnected Impervious Surface(DIS) 0
'1 Treatment Swale 0
2 Dry Pond 0
'3 StormFilter 0
'4 Silva Cell 0
'5 Bayfilter 0
'6 Filterra 0
LOAD SUPPLEMENT FORMS
!SIGNER CERTIFICATION
7 'Name and Title: Jeff Tibbitts
8 !Organization: CESO
9 Street address: 3601 Rigby Road,Suite 300
.0 City,State,Zip: _ Miamisburg,OH 45342
.1 'Phone number(§): [phone]
.2 Email: [e-mail]
Certification Statement:
I certify,under penalty of law that this Supplement-EZ form and all supporting information were prepared under my direction or supervision;that the
information provided in the form is,to the best of my knowledge and belief,true,accurate,and complete;and that the engineering plans,
specifications,operation and maintenance agreements and other supporting information are consistent with the information provided here.
Designer
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