SW6231202_Supplement-EZ Form_20240321

SUPPLEMENT-EZ COVER PAGE
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PROJECT INFORMATION
1 Project Name Dunn,NC-Petco
2 Project Area(ac) 1.68
3 Coastal Wetland Area(ac) 0
4 Surface Water Area(ac) 0
5 Is this project High or Low Density? High
6 Does this project use an off-site SCM? No
COMPLIANCE WITH 02H.1003(4)
7 Width of vegetated setbacks provided(feet) 30
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
10 Is streambank stabilization proposed on this project? No
NUMBER AND TYPE OF SCMs:
11 Infiltration System
12 Bioretention Cell 1
13 Wet Pond
14 Stormwater Wetland
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 Treatment Swale
22 Dry Pond
23 StormFilter
24 Silva Cell
25 Bayfilter
26 Filterra
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DESIGNER CERTIFICATION
27 Name and Title: Andrew Maysent
28 Organization: McClure Engineering Company
29 Street address: 335 SE Oralabor Rd
30 City,State,Zip: Ankeny,IA 50021
31 Phone number(s): 515-512-1361
32 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
SS/•
SEAL — Signature of Designer
045881 ti
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03.20.24
Seal Date