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Home My WebLink AboutTCEQ. ~ Notice of Intent (NOi) for Storm Water Discharges Associated with Construction Activity under TPDES General Permit (TXR160000) TCEQ Office Use Only Pennit No.: TXRIS RN: CN: Ref No: Sign up now for ePermits NOi at www6.tccg.state.tx.us/steers Get Instant Permit Coverage and only pay a $225 application fee. lffillag a paper NOi you can pay the application ree on line? Go to www.tccq.statc.tx.us/cpay Select Fee Type: GENERAL PERMIT CONSTRUCTION STORM WATER DISCHARGE NOi APPLICATION If ~ubmitting a pitpcr NOi, coverage under the general permit starts seven (7) days after the date postmarked for delivery to TCE . IMPORTANT: •Use the INSTRUCTIONS to fill out each question in this fonn. •Use the attached CUSTOMER CHECKLIST to make certain all you filled out all required infomlation. • ~ . ~ Ii · 'o 'WaL dela a .rov~ or result in a. tQOl th~ .D~ _ ;I. Renewal of General Permit Is this NOi to renew an ACTIVE permit? (!]Yes -What is your permit number? Permit No. TXRlS ey34 ONo - 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 payment of the application fee: (l]Ma.iled: Check/Money Order No.: 18264 Company Name on checlcing account: Brazos Valley Services Voucher No.: Is the Payment Voucher copy attached? (i]Yes .. • .. \, '' ·· .. 1;-;·, I. If the applicant is currently a customer with TCEQ, what is the Customer Number (CN) issued to this entity? CN (Sl'ard1 · Is ) 2. What is the Legal Name of the entity (applicant) applying for this permit? Brazos Valley Services (The legal lltl1M tllll.St ht s,¥1led uactly 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: Ric J PalasotA Job Title: OWNER 4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? (verify a1 l1SPS.coml Address: p. O. Box 985 Suite NoJBldg .. No./Mail Code: City: Bryan State: Texas ZIP Code: 77845 Country Mailing Information (if outside USA). Country Code: Postal Code: 5. Phone No.: ( 9-r=t) 2559272 6· Fax No.: < 97'f 8463159 7. Indicate the type of Customer: Blndividual Corporation Dstate Government Clother Government rCEQ-20022 (03IOS/2008) Extension: E-mail Address: epalaso@txcyber.com Dsote Proprietorship-D.B.A. DFederal Government O;ounty Government 00ther (describe): DLimited Partnership [!]General Partnership Deity Government Page I &. Independent Operator: [LJYes 0No (If governmental entity, subsidiary, or part of a larger corporation, check "No".) 9. Number of Employees: 00-20; 11]21-100; 0101-250; 0251-500; or 0501 or higher 10. Customer Business Tax and Filing Numbers (I'hls Item is not applicable to Individuals, Government, GP or Sole Proprietor.) RE UIRED for Co orations and Limited Partnershi s r v ... rif the entit,·'s status and filin no. with TX SOS at 5121463-:\555 State Franchise Tax ID Number: Federal Tax ID: 7 42978052 TX SOS Charter (fiiing) Number: DUNS Number (if known): . ·-.. ' . , .' ·. ::: .. ·.~·: ;~~.: ··> '·· .. ~ . ':.~.·.~-.. IfTCEQ needs additional information regarding this application, who should be contacted? 1. Name: Ric Palasota Title: Owner/Partner Company: Brazos Valle Services 2. Phone No.: ( 979 ) 2559272 Extension: t. TCEQ Issued RE Reference Number (RN): RN (Search Central Rcgistn) 2. Name of Project or Site (the name as known by the community where this facility/project is located): Edelweiss Gartens Phase 11 (example: phase and name of subdivision or name of project that's unique to the site) 3. Does the site have a physical address? HY es, complete ••• for a physical address. Ir No, complete for site location infonnation. Enter the physical address for the site. (verify it wifb USPS.com or other delivery source) Street Number: Street Name: City: ZIP Code: Enter the site location infonnation. lfno 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 & IH3S accessible on Hwy 290 South) Intersection of Victoria and Eagle Streets City where the site is located or nearest city to site: ZIP Code where site is located: College Station, Texas 77845 4. Identify the county where the site is located: Brazos S. Latitude:30 33 44 N Longitude: 96 17 48 W 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) new construction 7. What is the mailing address for the regulated entity? Is the RE mailing address the same as the Operator? ' es, address is the same as Operator No, provide the address Street Number: Street Name: City: State: ZIP Code: ~ . .. . ,.,, '·, .... .. .. 1. ls the site located on Indian Country Lands? [!]No 0Yes -If Yes, do not submit this NOi. Contact EPA, Region VI If the site is on Indian coun lands ou must obtain authorization throu h EPA Re ion VI. 2. What is the Standard Industrial Classification (SIC) code (see instructions for common codes): 1sc11rch Osha.go,·) Primary: 1611 Secondary: TCEQ-20022 (03/0"2008) Page2 ~(a) What is the total nwnber of acres disturbed? 14.13 ------------3(b) Is the project site part of a larger common plan of development or sale? Gvcs No 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 eneral rmit for small construction sites. 4(a) What is the name of the water body(s) to receive the storm water runoff or p0tential runoff from the site? Lick Creek 4(b) What is the segment number(s) of the classified water body(s) that the discharge or potential discharge will eventually reach? 4(c) Are any of the surface water bodies receiving discharges from the construction site on the latest EPA-approved CWA 303(d) list of impaired waters? Dves IZJNo If Yes rovide the name of the im aired water bod s. 4( d) Is the discharge into an MS4? Y cs [Z)No If Yes, what is the name of the MS4 Operator? __________________________ _ 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 [ZJNo If the 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. Check "Yes• to the certifications below. Failure to certify to i1ll items will result in denial. [l] Yes I certify that I have obtained a copy and understand the tenns and conditions of the general permit CTXR 150000>. [l] 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 . ./ Yes I understand that a Notice of Termination (NOT) must be submitted when this authorization is no longer needed. [l] 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 uired in the eneral ennit TXR150000. .·:·. 1, Rjcky J Palasota Owger Typed or printed name (Required & mu.\·/ ht< lc!gihlt!) Title (Required & legible) certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the infonnation submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the infonnation, the infonnation submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware there arc significant penalties for submitting false infonnation, including the possibility of fine and imprisonment for knowing violations. I further certify that I am authorized under ,&,ll;~~!Jlll~!!!~~i!.!1£M!l.:S~4 to sign and submit this document, and can provide documentation in Datc:_"Z_·_2_'1_·_0_~------ Page3 Texas Commission on Environmental Quality General Permit Payment Submittal Form $325 for a oaoer Construction NOi Ao1>Hcation Fee Use this fonn to submit your Application Fee only if you are mailing your payment. •Complete items 1 through 5 below: •Staple your checlc in the space provided at the bottom of this document. •Do not mail this form with your NOi fonn. •Do not mail this form to the same address as your NOi. Mail this form and vour check to: BY REGULAR U.S. MAIL BY OVERNIGHT/EXPRESS MAIL Texas Commission on Environmental Quality Texas Commission on Environmental Quality Financial Administration Division Financial Administration Division Cashier's Office, MC-214 Cashier's Office, MC-214 P.O. Box 13088 12100 Park 35 Circle Austin. TX 7871 1-3088 Austin, TX 78753 Fee Code: GPA General Permit TXRl50000 I. Check I Monev Order No: 18264 2. Amount of Check/Money Order: $100.00 3. Date of Check or Monev Order: 2·29-08 4. Name on Chcclc or Monev Order: Brazos Valley Services ~~:.: :' ,· ~~('~Y,,;f:' ,,:J;,.i:~ .. ' .:·.:\,,:·,., -~)>, · _::~ .-~.X .: .. ;:-..: :~\-· ···.~/l·"t;.·~t~"i-~>.>"ir!I: ,_ .. ·, .. 5. NOi INFORMATION If the checlc is for more than one NOi, list each Project/Site (RE) Name and Physical Address exactly as provided on the NOi. 00 NOT SUBMIT A COPY OF TI1E NOi WITII THIS FORM AS IT COULD CAUSE DUPLICATE PERMIT ENTRIES. See Attached List of Sites (If more soacc is needed. vou mav attach a list.) Project/Site (RE) Name: Edelwelas Gartens Phase 11 Project/Site (RE) Physical Address: Intersection of Victoria and Eagle Street, College Station, Texas 77845 Staple Check In This Space ~ <t?lo~ u--1< \ qD'6 ri·L TCEQ-20134 (3/0512008) Pagel TEXAS COMMISSION ON ENVIRONMENTAL QUALITY Texas Pollutant Discharge Elimination System Storm Water Construction General Permit The Notice oflntent (NOi) for the facility listed below was received on October 16, 2006. The intent to discharge stonn water associated with construction activity under the tenns and conditions imposed by the Texas Pollutant Discharge Elimination System (TPDES) storm water construction general permit TXR.150000 is acknowledged. Your facility's TPDES construction storm water general pennit number is: TXR15EY34 Coverage Effective: October 12, 2006 TCEQ's storm water construction general permit requires certain storm water pollution prevention and control measures, possible monitoring and reporting, and periodic inspections. Among the conditions and requirements of this permit, you must have prepared and implemented a storm water pollution prevention plan (SWP3) that is tailored to your construction site. As a facility authorized to discharge under the storm water cor.::;truction PROJECT/SITE: BRAZOS VALLEY SERVICES EDELWEISS GARTENS PHASE 12 BRAZOS County INTEX OF VICTORIA & EAGLE STREETS COLLEGE STATION, TX n840 OPERATOR: BRAZOS VALLEY SERVICE CO POBOX985 BRYAN, TX naos This permit expires on March 05, 2008, unless otherwise amended. For additional infonnation, see the TCEQ web site at www.tceq.state.tx.us, or contact the Storm Water Processing Team by telephone at (512) 239-3700 or e-mail at swpermit@tceq.state.tx.us. A copy of this document should be kept with your SWP3 . Issued Date: July 31, 2007 FOR THE COMMISSION TEXAS COMMISSION ON ENVIRONMENTAL QUALITY Texas Pollutant Discharge Elimination System Storm Water Con5tructfon General Permit The Notice oflntent (NOi) for the facility listed below was received on October 16, 2006. The intent to discharge storm water associated with construction activity under the terms and conditions imposed by the Texas Pollutant Discharge Elimination System (TPDES) storm water construction general permit TXR.150000 is acknowledged. Your facility's TPDES construction storm water general Eermit number is: TXR15EY34 Coverage Effective: October 12, 2006 TCEQ's storm water construction general permit requires certain storm water pollution prevention and control measures, possible monitoring and reporting, and periodic inspections. Amang the conditions and requirements of this permit, you must have prepared and implemented a storm water pollution prevention plan (SWP3) that is tailored to your construction site. As a facility authorized to discharge under the storm water co;;etniction PROJECT/SITE: BRAZOS VALLEY SERVICES EDELWEISS GARTENS PHASE 12 BRAZOS County INTEX OF VICTORIA & EAGLE STREETS COLLEGE STATION, TX 77840 OPERATOR: BRAZOS VALLEY SERVICE CO POBOX985 BRYAN, TX 77806 This permit expires on March 05, 2008, unless otherwise amended. For additional information, see the TCEQ web site at www.tceq.state.tx.us, or contact the Storm Water Processing Team by telephone at (512) 239-3700 or e-mail at swpermit@tceq.state.tx.us. A copy of this document should be kept with your SWP3. Issued Date: July 31 , 2007 FOR THE COMMISSION