HomeMy WebLinkAboutSite Notice----_. -- --... -
CONSTRUCTION SITE NOTICE
FOR THE
Texas Commission on Environmental Quality (TCEQ)
Storm Water Program
TPDES GENERAL PERMIT TXR150000
The following information is posted in compliance with Part 11.D.2. of the TCEQ General Permit Number
TXR150000 for discharges of storm water runoff from construction sites. Additional information regarding the
TCEQ storm water permit program may be found on the internet at:
http://www.tceq.state.tx.us/permitting/water_quality/stormwaterffXR15_AIR.html
Contact Name and Phone Number:
Project Description:
(Physical address or description of the site's
location, estimated start date and projected end
date, or date that disturbed soils will be
stabilized)
Location of Storm Water Pollution
Prevention Plan :
Todd Carnes
(979) 694-4040
Creek Meadows -Section 4, Phase 28
Located between Greens Prairie Trail & Greens Prairie Road W.
Estimated Start Date: 12/1/08
Estimated End Date: 1211/09
RME Consulting Engineers
P.O. Box 9253
College Station, TX 77842
For Construction Sites Authorized Under Part 11.D.2. (Obtaining Authorization to Discharge) the following
certification must be completed:
I Todd Carnes (Typed or Printed Name Person Completing This Certification) certify under penalty of
law that I have read and understand the eligibility requirements for claiming an authorization under Part 11.D.2. of
TPDES General Permit TXRI 50000 and agree to comply with the terms of this permit. A storm water pollution
prevention plan has been developed and implemented according to permit requirements. A copy of this signed
notice is supplied to the operator of the MS4 if discharges enter an MS4 system. I am aware there are significant
penalties for provi ing false information or for conducting unauthorized discharges, including the possibility of fine
an imprisonmen for knowing violations.
~
Signature and Title Date
IMPORTANT:
Notice of Intent (NOi) for Storm Water
Discharges Associated with Construction
Activity under TPDES General Permit
(TXR150000)
TCEQ Office Use Only
Permit No.: TXRl 5
RN:
CN:
Ref No:
Sign up now for ePermits NOi at bttps://www6.tceq.state.tx.us/steers/
Get Instant Permit Coverage and only pay a $225 application fee.
If filing a paper NOi you can pay the application fee on line? Go to https://www6.tceq.state.tx.us/epay/
•Use the INSTRUCTIONS to fill out each question in this form.
•Use the attached CUSTOMER CHECKLIST to make certain all you filled out all required information.
•Incom lete a lications WILL dela a roval or result in automatic Denial.
Renewal of General Permit
Is this NOi to renew an ACTIVE permit?
0Yes -What is your permit number? Permit No. TXRlS _______ _
[!]No -a permit number will be issued.
Application Fee if mailing a paper NOi:
You must pay the $325 Application Fee to TCEQ for the application to be considered complete.
Payment and NOi must be mailed to separate addresses. See instructions for correct mailing addresses.
Provide your payment information below, for us to verify paynient of the application fee:
OMailed: Check/Money Order No.: Company Name on checking account:
OEPAY: Voucher No.: Is the Payment Voucher copy attached? DYes
A. OPERA TOR (applicant)
1. If the applicant is currently a customer with TCEQ, what is the Customer Number (CN) issued to this entity?
CN (Search Central Re ist )
2. What is the Legal Name of the entity (applicant) applying for ilii.s permit?
Creek Meadows Partners, LP.
(The legal name must be spelled exactly as filed with the Texas Secretary of State, County, or in the legal document forming the entity.)
3. What is the name and title of the person signing the application?
(The person must be an official meeting signatory requirements in TAC 305.43(a).)
Name: Todd Carnes Job Title: General Partner
4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? (verify at USPS.com)
Address: 230 Southwest Parkway East Suite No./Bldg. No./Mail Code:
City: College Statio"n State:Tx ZlP Code: 77840
Country Mailing Information (if outside USA).
5. Phone No.: (979 ) 694-4040
6. Fax No.: < 979 ) 694-4141
7. Indicate the type of Customer:
D Individual
D Corporation
D State Government
Dother Government
TCEQ-20022 (03/05/2008)
Country Code: Postal Code:
Extension:
E-mail Address: tcarnes@creekmeadows.net
Osole Proprietorship-D.B.A.
0Federal Government
D::ounty Government
00ther (describe):
0Limited Partnership
0General Partnership
Deity Government
Page I
(l 0
8. Independent Operator: IZJYes 0 No (If governmental entity, subsidiaiY. or part of a larger corporation, check "No".)
9. Number of Employees: 00-20; 021-100; 0101-250; 0251-500; or 050 I or higher
10. Customer Business Tax and Filing Numbers (This item is not applicable to Individuals, Government, GP or Sole Proprietor.)
REQUIRED for Corporations and Limited Partnerships (Verify the entity's status and filin2 no. with TX SOS at 512/463-5555)
State Franchise Tax ID Number: Federal Tax ID:
TX SOS Charter (filing) Number: DUNS Number (if known):
B. APPLICATION CONTACT
IfTCEQ needs additional information regarding this application, who should be contacted?
L Name: Rabon A. Metcalf, P.E. I Title: Owner I Company: RME Consulting Engineers
2. Phone No.: ( 979 ) 690-0329 Extension:
3. Fax No.: 979 690-0329 E-mail Address: rabon@rmengineer.com
c. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE
I. TCEQ Issued RE Reference Number (RN): RN
(Search Central R£i:,ista)
2. Name of Project or Site (the name as known by the community where this facility/project is located):
Creek Meadows -Section 4, Phase 28
(example: phase and name of subdivision or name of project that's unique to the site)
3. Does the site have a physical address?
If Yes, complete Section A for a physical address.
If No, complete Section B for site location information.
Section A· Enter the physical address for the site. (verify it with USPS.com or other delivery source)
Street Number: Street Name:
City: College Station, TX ZIP Code:
Section B: Enter the site location information.
Ifno physical address (Street Number & Street Name), provide a written location access description to the site:
(Ex.: phase I of Woodland subdivision located 2 miles west from intersection .of Hwy 290 & IH35 accessible on Hwy 290 South)
Located between Greens Prairie Trail and Greens Prai rie Road W. ·
City where the site is located or nearest city to site: ZIP Code where site is located: ..
College Station, TX 77845
4. Identify the coupty where the site is located: Brazos
5. Latitude: N 30.53144 Longitude: W96.28204
6. What is the primary business of this entity? In your own words, briefly describe the primary business of the Regulated Entity:
(Do not repeat the SIC and NAICS code) High density residential development
7. What is the mailing address for the regulated entity?
ls the RE mallin·g address the same as the Operator? ~yes, address is the same as Operator LJ No, provide the address
Street Number: I Street Name: -City: ' I State: I ZIP Code:
D. GENERAL CHARACTERISTICS
1. Is the site located on Indian Country Lands? [ZJNo 0 Yes -If Yes, do not submit this NOi. Contact EPA, Region VI
If the site is on Indian country lands, you must obtain authorization through EPA, Region VI.
2. What is the Standard Industrial Classification (SIC) code (see instructions for common codes): (Search Osha.go\')
Primary: 1521 Secondary:
TCEQ-20022 (03/05/2008) Page 2
0 0 ---3(a) What is the total number of acres disturbed? 4 acres
3(b) Is the project site part of a larger common plan of development or sale? 0Yes LJNo
If Yes, the total number of acres disturbed can be less than 5 acres.
If No, the total number of acres disturbed must be 5 or more. If the total number of acres disturbed is less than 5 then the
project site does not qualify for coverage through this Notice of Intent. Coverage will be denied. See the requirements in the
general permit for small construction sites.
4. Discharge Information (aU information MUST be provided or the permit wilt be denied)
4(a) What is the name of the water body(s) to receive the storm water runoff or_ potential runoff from the site?
Peach Creek
4(b) What is the segment number(s) of the classified water body(s) that the discharge or potential discharge will eventually
reach? 1242
4( c) Are any of the surface water bodies receiving discharges from the construction site on the latest EPA-approved CW A
303(d) list of impaired waters?
0Yes (i]No
If Yes, provide the name of the impaired water body(s).
4(d) Is the discharge into an MS4? 0Yes C)No
If Yes, what is the name of the MS4 Operator? City of College Station
Note: The general permit requires you to send a copy of the NOI to the MS4 Operator.
4(e) Is the discharge or potential discharge within the Recharge Zone, Contributing Zone, or Contributing Zone within the
Transition Zone of the Edwards Aquifer?
:
0Yes []No
lfthe answer is Yes, please note that a copy of the agency approved Plan required by the Edwards Aquifer Rule (30 TAC Chapter 213) must
be included or referenced in 'the Storm Water Pollution Prevention Plan.
E. CERTIFICATION
Check "Yes~' to the certifications below. Failure to certify to all items will result in denial.
0 Yes I certify that I have obtained a copy and understand .the terms and conditions of the general ~rmit ITXR150000}. . . 0 Yes I certify that the full legal name of the entity (Operator) applying for this permit has been provided and is legally
authorized to do business in Texas. ' 0 Yes I understand that a Notice of Termination (NOT) must be submitted when this authorization is no longer needed.
[!]Yes I certify that a storm water pollution prevention plan has been developed and implemented prior to construction,
and'that is compliant with any applicable local sediment and erosion control plans and prepared and implemented
as required in the general permit TXRI 50000.
Operator Certification:
I, Iggg "~W~lii ~~C~t~I E!~i:lc~t Typed o_r printed name (Required & nu1st be legible) Title (Required & legible)
certify under penalty oflaw tltai this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personri~I properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate, and complete. I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
I further certify that I am authorized under 30 Texas Administrative Code §305.~ to sign and submit this document, and can provide documentation in proofof=hs;;Mn reqO<Sl
Date: lZ-lz..t:t /oe:s Signature: ___.--
-(Use blue ink) I
TCEQ-20022 (03/05/2008) Page3