SW3200801_O&M Agreement_20200911

Operation & Maintenance Agreement
Furr Comercial Building
Cabarrus County, NC
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 & c
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Bioretention Cell
Quantity:
Wet Pond
Quantity:
Stormwater Wetland
Quantity:
Permeable Pavement
Quantity:
Sand Filter
Quantity:
Rainwater Harvesting
Quantity:
Green Roof
Quantity:
Level Spreader - Filter Strip
Quantity:
Proprietary System
Quantity:
Treatment Swale
Quantity:
Dry Pond
Quantity:
Disconnected Impervious Surface
Present:
User Defined SCM
Present:
Low Density
Present:
0.
0
0
0
0
v
0
0
0
0
0
0
ng O&M sheets will be added automatically):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Type: [Vegetated swales/roadside ditches
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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.
Signature:
Project Name:
Project Location:
Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s)-
Email:
Tim Furr
5515 Shoreview Drive
Concord, NC 28205
704-791-2849
[e-mail]
/ Date:—Z�r_--
n Y t' -e Y1 a Notary Public for the State of C,
County of C, -f Y VI do hereby certify that r
personally appeared before me this (� day of A{h c4 4l .5 � `�(� and
acknowledge the due execution of the Open_ tions and Mainte ance Agreement.
r
Witness my hand and official seal, -
Jean Greene
Notary Public
Cabarrus Couni
_ North. Carolina
i I ,
Seal My commission expires <�
STORM-EZ
Version 1.5 O&M Agreement
8/12/2020
Page 1 of 1