SW6191202_SuppEZ Form Signed_1/23/2020

SUPPLEMENT-EZ COVER PAGE
LOAD SUPPLEMENT FORMS
PROJECT INFORMATION
1 Project Name
2 Project Area (ac)
_3 (Coastal Wetland Area (ac)
_4 (Surface Water Area (ac)
5 Is this project High or Low Density?
6 Does this nroiect use an off -site SCM?
Allendale 115 kV Substaton
3.5
— 0
0
Low
No
COMPLIANCE WITH 02H .1003(4)
7
Width of vegetated setbacks provided feet
0
8
Will the vegetated setback remain vegetated?
No
9
Is BUA other that as listed in .1 0034 (c-d) out of the setback?
Yes
10 11s streambank stabilization proposed on this project?
No
NUMBER AND TYPE OF SCMs:
L 11 Infiltration System
12 Bioretention Cell
13 Wet Pond
14 Stormwater Wetland
0
0
0
0
0
0
0
0
0
0
15
Permeable Pavement
16 Sand Filter
17 Rainwater Harvesting (RWH)
18 Green Roof
19 Level Spreader -Filter Strip (LS-FS)
20
Disconnected Impervious Surface (DIS)
21
1 Treatment Swale
0
22
Dry Pond
0
23 StormFilter
0
24 Silva Cell
0
25 Bayfilter
0
26 Filterra
0
LOAD SUPPLEMENT FORMS
DESIGNER CERTIFICATION
27 Name and Title:
28 Organization: _
29 Street address:
Phone
Email:
William Chris Crosby
ECE
115 Oakland Ave, Suite 102
Rock Hill. SC 29730
=rn
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.
CAS
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Signature of Designer
Date