HomeMy WebLinkAbout03-00500153- 00076409 . Rug 05 2003 4:59PM Greens Prairie Investors 979 -G90 -1041 p.2
AuC 05 03 09:458 TEXCON ENGINEERING 8797647759 p -4
Notice of Intent (NO1) for Storm Water Discharges TGEQ Office Use Only
F = Associated with Construction Activity under the TPDES Permit Nurnt>cr; 'i X►215•• - -•- NO
TPDES Construction General Permit (TXR150000) GIN Number: - - — -- .. •• •• -• ••
TCEQ For M•.l(t u,ngrktuty Uri aPpfClltion. ICJ the IXI(1r 1OD0 M I bv.th.w Ylhr
(TCF Q• 7oo2Y- 4, Nnu>I inrts ).
A. Construction Site Operator ®Nvw flNo Change __I¢� Customer Reich :ltl;. Number: (A Narnc: ?Tijr t' a.F.1,tel _ ._.. ._. __. - --
M,sitirlg /lddross: 4 (1Q Cc� 5tie -in j -- i s C.11y p(C e STehat itwttai Zip Cade: _1
Country Mailing In1Wn4rltet irf o(dvtlo t!SA Tnfritoy:. _.. -_ Country Code: _ ___ _
(4 ` l Por-lal Cude.
Phone Number: //
0 — Z TSo ..._. PRl onsbn: -- _..... hart Nu mber l`n `i�� `LD_- MIL__ -..
F - rn.oi IAddress: -- _ _
typo of Operator 0 Individual 0 :car. Pruprw4or! I rp - D.O.A. oci Panihlrslhi 0 Corporation 0 fr-dr_ GI ootuvntnd
S1a1e Government 0 Cnlmty Cover/intent 0 City Government 0 Other:
Independent Op . t. r r
Yes 0 No Numbor of Empl yvos: 20 0 21 -100 0 101 -2w 0 2L �o
1 0 501 ire hitP
federal Tar /0:1T suite 1 :r;1rlthise Tox ID Nr rnther: /,./ Q/ Mite.; N.irnb r; pi _
8. Bluing Addr it .
Moue: ...__ - 1 p5 — PrQ.c.1. ► e.. IAA kt ?' & t-�� - .. --
Mailing Address: _ 4'' f (2'il VC... _ _ City_ • t;aSlato:X Zip Corte- 17. }_ •
Country M»Ihng Inlorrnatiot► (11 eu .ido OS/1) Territory: _ „_. . Country ode: — Pecan Corot:
C. Project! Site information (,New []NO Chongc / Rtjulated LnUly Ttolerencc Numnnr fiN �
-,m
Nc: _ �ir t1 !& ` -” . d.D - rl.j 11 (Z �i 13 .....
Mailing Address: :3 • i '..t' S� •• 1�)Vid'C City: rei1t'�IQ_5r��.a, i Stator_L Zip Cudu: "77' .4�
PhySiCcd Address: — J _ City: J : ••YY d - M c Zip Gude.
Location c
Aela Description: C ' Si-` . Cc SP t e t.[.jAr,y6 R ie • i s Cpt,nt
t.atiludd:r Z l" N Longit(Mtc: •tu• ' " W Degrees ('). Minutes f), and Seconds: ( -)
latitude'— _...._- ...._— Longittdle• - —_. - -. . Decimal form
Standard Indur ial Classifica ion (SIC) oodr-: 1102_ Also. describe seta c /,nsln,r:tion ;bGGvity at thin :i:te (do out reps n r Ilrc SIC mole.):
Li/ 41 40 7 CrIlr0( 1 ")
Hos a storm w ter pollution prevention plan been prepared an sper.it.i ci In the general permit (TXR1,0e00)Y (Yes Q No
Estimated afrit of food disturbed (to the nearest acre): Zk - is use project ( site Iocrnted on Indian Country Lartd0 0 Yin IX Nu
Does tills project / site diocforgc 31(14,n w 4Ser httO o ntunicbat .aparnl0 storm sewet syaem (MSd)? 0 Vcs OD No
If yes. provide the name of the MS4 operator: _ 1
Provide• the mare or s ogmen* number of the water body that ttwaives storm water town this prviecl ! cite: r - 1 e • Cre4 -- _ _
__
_
D. Contact - If the TCEQ needs a¢d Informali(rt regarding this, application, veho should be contoured,
Name: WOIk m t(l.tP4 T :, t
Phone Mtndler: `C1i[tT O- 1258 Extension: - - fox N u Or:,4114142/ - J Q4
Email Aitarev s:
E. Payment Information • Chect / Money Ordty NpmDer:1095 N,wiiu un Check l Money (kdnr t:"e1,Zi ''(�31T�!3j .• . Lau
F. Certification
I certify under penakyat )der baps hits 40Cument was preo:rod rester my o recinn to uvNvrv::iton in aoctudMCC %OM a ayslam designed to er,;;un: tluil crralillvu
Dnrsonnel tNOpaly gather ant tw :Iunk: the irtrorsnahoneuhmilted. [lased on my inrtuiev M the parson ar pwaons vino man44ge Ilse system, ro n4.4.1 (tr,,,A! me
dweeey rexprineitlu fur galhoema the information, the Information eu**MIW'd I. to the tittst M easy knowledge sad belief. five, 4CCwdlu. and comptate. I am
aware there are sigMfit fns portables. km submitting take InformaIion :rt.lueiny tlw pa svi iley M lino mitt iinensonmcnl for knowing viu11J1k,n1.
Construction Site Operator:
Prefix: _M, First a. iar_ Mlddlo:
Last - 1Afti tt1 >L ���,( - Suffer: _Trap: WIR E, Q
Slgnaturo: —4: Lr - --_ _ Tome -1( 10 •05 • _._
t you have questions un how io Ili out this ewes pr LUDO the storm wale program, fIeeee CnnlCCt vO el (512) 239 -4671
fitrniv■dt rats we omitted to request and rowan Moir per1On,tlgemination lhMth4J0CnCy gaeiers on en trirrnt They tm:y also have any error: in emir infornsetin..
eorrocIup. To review Such h- can s nr, l oNud us at )S12) 23,
The completed NOI muss taw mailed to Iho following oddroac. the Ilse attached document to submit the 5100
application foe. Pl000e note aux the NOI and sprilicallon foe are Submitted s000ralcly to dint:tem addreSseO.
Texas Commission on Environmrwltat Quality
Storm water & General Permits Team: MC - 228
P.O. Box 13087
Austin. Texas 7$1711-3087
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