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EXHIBIT C <br /> 201 Marshall Street <br /> V. Summary of Inspections and Maintenance: <br /> Use the attached FloGard Perk Filter Operations and Maintenance Manual to conduct <br /> inspections monthly(or as needed), identify needed maintenance, and record <br /> maintenance that is conducted. <br /> VI. Sediment Removal: <br /> Total amount of accumulated sediment removed from the storm water treatment <br /> measure(s) during the reporting period: cubic yards. <br /> How was sediment disposed? <br /> ❑ landfill <br /> ❑ other location on-site as described in and allowed by the maintenance <br /> plan <br /> ❑ other, explain: <br /> VII. Inspector Information: <br /> The inspections documented in the attached Inspection and Maintenance Checklists were <br /> conducted by the following inspector(s): <br /> Inspector Name and Title Inspector's Employer and Address <br /> VIII. Certification: <br /> I hereby certify, under penalty of perjury, that the information presented in this report and <br /> attachments is true and complete: <br /> Signature of Property Owner or Other Responsible Party Date <br /> Type or Print Name <br /> Company Name <br /> Address <br /> Phone number: Email: <br /> Page 2 O&M lnspection Report <br />