HomeMy WebLinkAboutNOI,_, Notice of Intent (NOi) for Storm Water TCEQ Office Use Only
Pern1it No.: •r= Discharges Associated with Construction RN:
Activity under TPDES General Permit CN: • II
TCEQ (TXR150000)
~ Sign up now for on line NOi at hcip:/lwww.1ccq.state.lx.us/pc11nitting!s1ccrs/stcers.html
Did you know you can puy on line? Go to hllps://w,vw6.tceq.stiue.lx.us/cpay/ .. Select Fee Type: GENERAL PERMIT CONSTRUCTION STORM WATER DISCHARGE NOi APPLICATION
Application Fee: You must pay the SI 00 Application Fee to TCEQ for the application to be considered complete.
How did you oav U1is Cee?
L JMailed I ChecldMonev Order No.: I Name Printed on Cbt:ek:
L JEPAY I Yol)cher No.: I Is the Pavment Voucher copy attached? l JYes
®ORT ANT:
•Use the nttac!ied lNST.RtJGTION:S when completing t!1isJ9,ttll.
•Aft.er completing tllis fo1111, use.l!te aliached CUSTOME:tlClI.F:CI<J.IST to make certain all items are complete and a<;curate.
•Missir,ie., illee.ible, or Inaccurate items rnuy delay final aciµ1owledgrnent or coverage under the ite.nerdl oennit.
:>~, OFERATOR fannJlcal10 ·~ ,.~,~1 ~. h r: ;_,,.; ,. ; '• .• , " ,.,,,,+ ... ·.~·: .. ·'· ifi~/1''~ .~·~~:< + -~""' 1, If the applicaQt is c"11treutly a cusiomer with TCEO, what is the Customer Number (CN) issued to this entity? CN
2. What is ihe full LegafName ofthe applicant?
CA NEW PLAN TEXAS ASSETS , L.P.,a Delaware limited partnership
(The legal name must be snelled e.Xactlv as tiled with the Texas Secretary of S/11/e, County, or in the legal document formimuhe enlitv.J
3. Whai is ihc aoolic;mt's 111ailin2 address as reco!).nized by the US Postal Service?
Address:3901 Bellaire Blvd. I Suite NoJBldg. No./Mail Code:
City: Houston I State: Texas I ZIP Code: 77025
Country Mailing Information (if outside USA). Country Code: Postal Code:
4. Phone No.: ( 713 ) 6604359 I Extension:
5. Fax No.: ( 713 ) 3490901 I E-mail Address: rscott@newplanexcel.com
6. Indicate the type of Customer: CJ Individual 0 Sole Proprietorship-D.B.A. lZJ Limited Partnership CJ Corporation a Federal Government D General Partnership a State Government County Government OCity Government
Other:
7. lndepcndCQt Operator: I, IYes l.JNo (If governmental entity, subsidiary, or part of a larger corporation, check "No".)
8. Number o( Em\'.llovces: I 10-20; 11 121-100· I JIOl -25 0; I 12) 1-500; or LJ50 I or higher
9. Customer Business Tax and Filing Numbers (This item is 1101 applicable to Individuals, Government, GP or Sole Proprietor.)
:~EOUIRED for Corporations and Limited Partnershios
S.tiite Franchise TaX. fD Number: I Federal Tax ID: 760645623
TX SOS Charter (filing) Number: 13592411 I DUNS Number:(ifknown):
B. QlLLlNG ADDRESS ~· .
Tbe Operaior is tespeiisible for paying lhc annual fee. 111e annual fee will be assessed lo pcnnits active on Sc.ptembcr l of each year. TCEQ will send a blll
to the address provided in this section. The Operator is responsible for tcnninating the pennit when it is no longer needed.
ls the billing address same as the Operator Address? l.i.JYes, go to Section C. LJNo, fill out Scciion B
1. Billing Mailing Address: I Suite No.!Bldg. No.!Mail Code:
City: I State: I ZIP Code:
2. Country Mailing Information (ifoulside USA). Territory Country Code: Postal Code:
3. Billing Contact (Attn or CIO):
4. Phone No.: ( ) I Extension:
5. Fax No .: ( ) I E-mail Address:
C. APPLICATION C()NTACl' ,,, "':! .·. F ;. > ; ' .•.. '"f·:l~ > ~ ~f~~f . .. ~-,; .. ~~.':... ,.
lfTCEQ needs additional infonnation regarding this application, who should be contacted?
1. Name: Robert Scott I Title: Vice President CA NEW Pi.AN lEAA.S ASSETS. L,P • .a O..•w.v• lfn•-1 (111~ I Company: . "
2. Phone No.: (713 ) 6604359 I Extension:
3. Fax No.: 713 3490901 I E-mail Address: rscott@newplanexcel.com
TCEQ-20022 (10/01 /2006) Pago I
!." • "t. . D. REGULATED ENTITY (RE) INFORMATION ON P~OIBCT OR SITE '
I. TCEQ Issued RE Reference Number (RN) (if available):
2. Name of Project or Site (the name as known by the community where tl1is facility/project is located):
Culpepper Plaza Redevelopment
(exaroole: phase and name ofsubdivi.sion or name oforoiect thar's unique to the site)
3. Physical Address of Project or Site: (enter in spaces below)
Street Number. 1700 I Street Name: South Texas Avenue
City: College Station I zrp Code: 77840 I County (Counties if> I):
4. If no physical address (Street Number & Street Name), provide a written location access description to the site:
5. Latitude: 30 37' O" N I Longitude: 96 19' 7.4" 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 repeal the SICahd NAICS code) Development of Commercial Real Estate
7. What is the mailing address and. contact infonnation for the regulated entity?
,.
Is the RE mailing address the same as the Operator? [z:;JYes, address is the same as Operator 0No, provide tl1c address
Street Number. I Street Name:
City: I State: I ZIP Code: ...... ""~ .. '~·· 'l'J . ,.
I. I certify that the projeet/site is l\Ot located 011 Indian Counny Lands?
lfNo, vou must obtaiq autboriwtion ihrou~h EPA, Region VI
2. IS this NOl being silbm'it!ed dHe to a change in OwnerorOperator?
[ZJYes
nves
3. What is the Standard Industrial Classification (SIC) code (see instructions for common codes):
Primarv: 1542 Secondary:
4, What is the total number of acreS disturbed?
Is the project site part of a larger common plan of development or sale? 0Ycs [Z]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 tlicn the project site does not qualify for
coverage through this Notice of lntent Coverage will be denied. See the requirements in U1e general permit for small consnuction sites,
5. Discharge Information
a What is the name of the first water body to receive the ston11 water runoff or potential runoff from the site? Wolf Pen Creek -Tributary B
b, What is the segment D\lmbet(s) of the classified water body(s) that the discharge or potential discharge will eventually reach? Wolf Pen Creek
c. lstbedischaJ!!einto11n.MS4? WYes LJNo
If Yes, what is th.e name of the MS4 Operator? City of College Station
Note: The ~cneral permit reQui.rcs you to send a copy of the NOi to the MS4 Operator,
6. Is the discharge or µOtential discharge within the Recharge Zone, Contributing Zone, or Contributing Zone within the Transition Zone
of the Edwards A qui for? D Yes 0 No
If the answer is Y cs, please note that a copy of the agency approved Plan required by the Edwards Aquifer Rule (30 TAC Chapter 213) must
.be included in the,Storm WatecPollution Prevention Plan.
'"-11:· r 1DER1JFfOATil)N ~ If '(i *;' %ii"'' '' ' ."1' '1~(. ·-\'*" ' · ::: '" ""· ' ~· W'.\t'i<!("'' "'
Check "Yes" to the certifications below. Failure to indicate "Yes' to ALL items may result in denial ofcoverage under the general permit.
I certify that I have obtained a copy and Understand the tcmis and conditions of the general permit TX 150000.
l certify that the uctivities at this ~itc; qualify for coverage under the general rx:m1it TXI 50000.
J understand that a Notic~ ofTcnbination (NOT) must be submilled when this authorization is no longer needed.
I understand that permits active on Septemtcr !st of each year will be assessed an Annual Water.Quality Fee.
l certify that a Storm Water Pollution Prevention Plan (SWP3) has been prepared and implemented as required by the general permit.
·v.,,,
, ' ~!~--i lQp~rator Certific11tiQ!): ' ·,,·
1, Robert Scott Vice President
Typed or printed name (Req1<ired) Title (Requlred)
~hes
IZ!Yes
[£]Yes
G]Yes
[L]Yes
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 information submitted, Based on my inqui1y of the person or persons who manage the system,
or U1ose persons directly responsible for gathering the infonnation, 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, incl uding the possibility of fine and imprisonment for knowing
violations.
I further,~ertif that I am authorized un,~O Texas Administrative Code §305.44 to sign and submit this documelll, and can provide doc11mentation in proof
of such a t oriz ion upon ~est _
Sign.atur ... J.'::: . . ~ Date: \ ?,.\ \3\ Q\D -(Use blue ink) -~---t-...=.+-=----------
TCEQ-20022 (10/0112006) Page2