SW3241004_O&M Agreement/Plan_20241118

Operation & Maintenance Agreement
Project Name: Central Cowboy Church
Project Location: 11777 US-601, Midland, NC 28107
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& corresponding 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: Yes Type: Dispersed flow only
I acknowledge and agree by my signature below that 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: Central Station Cowboy Church Inc
Title& Organization: Owner
Street address: 11777 US-601
City, state, zip: MIDLAND, NC, 28107
Phone number(s): 980-521-6371
Email: [e-mail]
Signature: Date: OL±-2,1)k 2--cF
I, - �^c S' , a Notary Public for the State of ttC—
County of , do hereby certify that --SC-4 SA-%A L
personally appeared before me this $ day of 0b.e-1/4._ f �}po1 (,,t and
acknowledge the due execution of the 0iLa&9 ..
rations and Maintenance A reement .
Witness my,„" ,Sand,official seal, '9'K , :�I3 '%
A a
I
.a ''" _w tau! a Z'
°
B�"�`h @mavmvAmo
�
_ ''r4Us COO
Seal My commission expires O l 2 g
STORM-EZ ( 10/21/2024
Version 1.5 O&M Agreement Page 1 of 1

Low Density Maintenance Requirements
Important maintenance procedures:
The drainage area to the vegetated conveyance or vegetated receiving area will be carefully managed
to reduce the sediment load to the vegetated conveyance or vegetated receiving area.
After the initial fertilization to establish the grass in the vegetated conveyance or the vegetated receiving
area,fertilizer will not be applied to the vegetated receiving areas.
The vegetated conveyance or vegetated receiving area will be inspected quarterly. 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.
SCM element: Potential problem: How to remediate the problem:
Vegetation Vegetation is too short or Maintain grassed vegetation such that the swale or vegetated
too long. area does not erode during the peak flow from the 10-year storm
Trash/debris is present. Remove the trash/debris.
Vegetated receiving Areas of bare soil and/or Regrade the soil if necessary to remove the gully, and then re-
areas erosive gullies have sod (or plant with other appropriate species)and water until
formed. established. Provide lime and a one-time fertilizer application.
Clogging has occurred. Clean out the outlet device. Dispose of the sediment off-site.
The outlet device(if
applicable)
The outlet device is Repair or replace the outlet device.
damaged
Erosion or other signs of
damage have occurred at Repair the damage and improve the flow dissipation structure.
the outlet.
The receiving water Discharges from the site
are causing erosion or Contact the local NCDEQ Regional Office.
sedimentation in the
receiving water.
1