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Home My WebLink AboutNOITCEQ -20022 (03/05/2008) age TCEQ Office Use Only for Storm Water Permit No.: TXR15 with Construction RN: General Permit CN: Ref No: � — Notice of Intent (NOI) �` Discharges Associated ti Activity under TPDES TCEQ (TXR150000) Sign up now for eeerrn its .Nt0i Get Instant Permit Coverage ° If filing a paper NOI you can pay the J�op J at w vwtbtcetl.state.tx.usisteers and only pay a $225 application fee. application fee on line? Go to https: / /www6.tceq.state.tx.us /epay/ IMPORTANT: •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. •Incomplete applications WILL delay approval or result in automatic Denial. Renewal of General Permit Is this NOI to renew an ACTIVE permit? Yes - What is your permit number? Permit No. TXR15 icy- a permit number will be issued. Application Fee if mailing a paper NOI: You must pay the `i`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: Mailed: Check/Money Order No.: q �� Company Name on checking accoun Pepper - Lawson Construction, L.P. EPAY: Voucher No.: Is the Payment Voucher copy attached? Ycs A. OPERATOR (applicant) 1. If the applicant is currently a customer with TCEQ, what is the Customer Number (CN) issued to this entity? CN 602612467 (Search Central Reeistrv) 2. What is the Legal Name of the entity (applicant) applying for this permit? Pepper- Lawson Construction, L.P. (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: Paul E. Lawson Job Title: President 4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? (verify at USPS.com) Address: 4555 K aty - Hockley Cut -Off Rd Suite No. /Bldg. No./Mail Code: City: Katy State:TX ZIP Code: 77493 Country Mailing Information (if outside USA). Country Code: Postal Code: 5. Phone No.: ( 281 ) 371 -3100 Extension: 6. Fax No.: ( 281 ) 371 -2029 E -mail Address: 7. Indicate the type of Customer: ❑ Individual ❑Sole Proprietorship- ❑Corporation ❑Federal Government ❑ State Government nCounty Government ❑Other Government ❑ Other (describe): D.B.A. ✓ Limited Partnership ❑General Partnership ❑City Government TCEQ -20022 (03/05/2008) age 8. Independent Operator: ■ Yes GI No (If governmental entity, subsidiary, or part of a larger corporation, check "No ".) 9. Number of Employees: ■ 0 -20; 11121-100; n 101 -250 ■ 251 -500; or ■ 501 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 , v .-ir ,,... ,,os < st:91"1 :11,,1 t;s1,,, n,, N1t1, rX 4OS :,+ ;s ? /- u4 ; - »- State Franchise Tax ID Number: 36- 4217631 Federal Tax ID: 1- 3642170 TX SOS Charter (filing) Number: CO10695 -10 DUNS Number (if known): 15- 748 -3793 B. APPLICATION CONTACT If TCEQ needs additional information regarding this application, who should be contacted? 1. Name: Joe E. Street Title: Project Manager I Company: Pepper- Lawson Const. 2. Phone No.: ( 713 ) 702 -7438 Extension: 3. FaxNo.: 979 690 - 9432 E-mail Address. j s treet @pepperlawson.com C. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE 1. TCEQ Issued RE Reference Number (RN): RN t , , eh central lieuiar 2. Name of Project or Site (the name as known by the community where this facility/project is located): College Station I.S.D., Greens Prairie Elementary School (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 l `SPS.cont or other delivery source) Street Number: 4315 Street Name: Greens Prairie Trail City: College Station ZIP Code: 77845 Section B: Enter the site location information. If no physical address (Street Number & Street Name), provide a written location access description to the site: (Ex.: phase 1 of Woodland subdivision located 2 miles west from intersection of Hwy 290 & IH35 accessible on Hwy 290 South) City where the site is located or nearest city to site: ZIP Code where site is located: 4. Identify the county where the site is located: Brazos County 5. Latitude: 30.520772 Longitude: - 96.293681 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) Elementary School 7. What is the mailing address for the regulated entity? Is the RE mailing address the same as the Operator? QYes, address is the same as Operator ' No, provide the address Street Number: 1812 Street Name: Welsh cit.- College Station State: TX ZIP Code: 77840 D. GENERAL CHARACTERISTICS 1. Is the site located on Indian Country Lands? Q No ❑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.aov) Primary: 8211 Secondary: • TCEQ -20022 (03/05/2008) Page 2 3(a) What is the total number of acres disturbed? 46.027 3(b) Is the project If Yes, the total If No, the total project site does general permit site of a larger common plan of development or sale? ❑ Yes El No part number of acres disturbed can be less than 5 acres. number of acres disturbed must be 5 or more. If the total number of acres disturbed is less than 5 then the not qualify for coverage through this Notice of Intent. Coverage will be denied. See the requirements in the for small construction sites. 4. Discharge Information -="i` -: 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? 1209 4(c) Are any 303(d) list of Yes If Yes, provide of the surface water bodies receiving discharges from the construction site on the latest EPA - approved CWA impaired waters? / No the name of the impaired water body(s). 4(d) Is the discharge If Yes, what Note: The into an MS4? / Yes No is the name of the MS4 Operator? City of College Station, Texas general permit requires you to send a copy of the NOl to the MS4 Operator. 4(e) Is the discharge Transition Zone Yes If the answer is be included or or potential discharge within the Recharge Zone, Contributing Zone, or Contributing Zone within the of the Edwards Aquifer? O No Yes, please note that a copy of the agency approved Plan required by the Edwards Aquifer Rule (30 TAC Chapter 213) must 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. ✓ Yes I certify that I have obtained a copy and understand the terms and conditions of the general permit (TXR 150000). 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. ✓ Yes I certify that a storm water pollution prevention plan has been developed and will be implemented prior to construction, and that is compliant with any applicable local sediment and erosion control plans, as required in the general permit TXR150000. ✓ Yes Operator Certification: 1, Paul E. Lawson President certify under penalty to assure that qualified system, or those accurate, and complete. knowing violations. I further certify proof of such authorizatio Signature: Typed or printed name (Required & must he legible) Title (Required & legible, of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for that I am authorized under 30 Texas Administrative Code 005.44 to sign and submit this document, and can provide documentation in upon request. -" C/ ` °^'`— Date:_ to /b (Use blue ink) TCEQ -20022 (03/05/2008) Page 3 TCEQ -20022 (03/05/2008) Page 1 TCEQ Office Use Only for Storm Water Permit No.: TXR15 with Construction RN: General Permit CN: Ref No: _— Notice of Intent (NOI) `` Discharges Associated Activity under TPDES TCEQ (TXR150000) Sign up now for ePermits NOI Get Instant Permit Coverage •goes• If filing a paper NOI you can pay the Select Fee Tyne: GENERA1. PERMIT at https: / /www6.tceu.state.tx.us /steers/ and only pay a $225 application fee. application fee on line? Go to https : / /www6.tceq.state.tx.us /epay/ CONSTRUCTION STORM WATER DISCHARCiF NOI .APPI [CATION IMPORTANT: •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. •Incomplete applications WILL delay approval or result in automatic Denial. Renewal of Is this NOI General Permit to renew an ACTIVE permit? - What is your permit number? Permit No. TXR15 - a permit number will be issued. Yes No 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: Mailed: Check/Money Order No.: Company Name on checking account: EPAY: Voucher No.: Is the Payment Voucher copy attached? Yes A. OPERATOR (applicant) 1. If the applicant is currently a customer with TCEQ, what is the Customer Number (CN) issued to this entity? CN (Search Central Registry) 2. What is the Legal Name of the entity (applicant) applying for this permit? College Station Independent School District (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: Jon Hall Job Title: Director of Construction Services 4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? (verify at USPS.com) Address: 1812 Welsh Suite No. /Bldg. No. /Mail Code: City: College Station State: Texas ZIP Code: 77840 Country Mailing Information (if outside USA). Country Code: Postal Code: 5. Phone No.: ( 979 ) 694 -5610 Extension: 6. Fax No.: ( 979) 694 -5612 E - mail Address: @csisd.Org 7. Indicate the type of Customer: Proprietorship- Government Government (describe): Individual ® Sole D.B.A. • Limited Partnership Corporation I® Federal ® General Partnership ® State Government OCounty ® City Government •Other Government Other Independent School District TCEQ -20022 (03/05/2008) Page 1 8. Independent Operator: ® Yes ■ No (If governmental entity, subsidiary, or part of a larger corporation, check "No".) 9. Number of Employees: ■ 0 -20; • 21 -100; ®101 -250; ■ 251 -500; or 0501 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 filing 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 If TCEQ needs additional information regarding this application, who should be contacted? 1. Name: Title: Company: 2. Phone No.: ( ) Extension: 3. Fax No.: E -mail Address: C. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE 1. TCEQ Issued RE Reference Number (RN): RN (Search Central Registry) 2. Name of Project or Site (the naive as known by the community where this facility /project is located): Greens Prairie Elementary School (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 . ction A for a physical address. If No, complete Section B for site location information. �ttA Enter the physical address for the site (verify it with USPS.com or other delivery source) Street Number: Street Name: City: ZIP Code: n �y Enter the site location information. If no physical address (Street Number & Street Name), provide a written location access description to the site: (Ex.: phase 1 of Woodland subdivision located 2 miles west from intersection of Hwy 290 & IH35 accessible on Hwy 290 South) City where the site is located or nearest city to site: South Corner of Greens Prairie Road and Royder ZIP Code where site is located: 77845 4. Identify the county where the site is located: Brazos 5. Latitude: 30d. 54m. 12s. Longitude: -96d. 17m. 24s. 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 NAILS code) Grading, utility installation, paving and building construction 7. What is the mailing address for the regulated entity? Is the RE mailing address the same as the Operator? UYes, address is the same as Operator Ei No, provide the address Street Number: Street Name: City: State: ZIP Code: D. GENERAL CHARACTERISTICS 1. Is the site located on Indian Country Lands? E No ❑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.gov) Primary: 1542 Secondary: TCEQ -20022 (03/05/2008) Page 2 3(a) What is the total number of acres disturbed? 46.027 acres 3(b) Is the project If Yes, the total If No, the total project site does general permit site of a larger common plan of development or sale? Yes MI No part number of acres disturbed can be less than 5 acres. number of acres disturbed must be 5 or more. If the total number of acres disturbed is less than 5 then the not qualify for coverage through this Notice of Intent. Coverage will be denied. See the requirements in the for small construction sites. 4. Discharge Information (all information MUST be provided or the permit will 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? Tributary to 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? 1209 4(c) Are any 303(d) list of Yes If Yes, provide of the surface water bodies receiving discharges from the construction site on the latest EPA - approved CWA impaired waters? i No the name of the impaired water body(s). 4(d) Is the discharge If Yes, what Note: The into an MS4? R, Yes ■ No is the name of the MS4 Operator? CitV Of College Station 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? ® Yes ® No 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. E. CERTIFICATION Check "Yes" to the certifications below. Failure to certify to all items will result in denial. I certify that I have obtained a copy and understand the terms and conditions of the general permit (TXR150000). n 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. 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 TXR150000. I ' I Yes I J Operator Certification: certify under penalty to assure that qualified system, or those accurate, and complete. knowing violations. 1 further certify proof of such authorization Signature: Typed or printed name (Required & must be legible) Title (Required & legible) of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for that I am authorized under 30 Texas Administrative Code 4305.44 to sign and submit this document, and can provide documentation in upon request. Date:_ (Use blue ink) TCEQ -20022 (03/05/2008) Page 3 Site - Specific TPDES Authorization Number: Operator Name: Pepper- Lawson Construction, L.P. Contact Name and Phone Number: John Morgan (713) 702 -7439 Project Description: Physical address or description of the site's location, and estimated start date and projected end date, or date that disturbed soils will be stabilized. Greens Prairie Elementary School 4315 Greens Prairie Trails, College Station TX Project Start: May 19, 2010 Project End: July 01, 2011 Location of Storm Water Pollution Prevention Plan: On -site Job Office Trailer MOM N OV N IP LARGE CONSTRUCTION SITE NOTICE FOR THE Texas Commission on Environmental Quality (TCEQ) Storm Water Program TPDES GENERAL PERMIT TXR150000 "PRIMARY OPERATOR" NOTICE This notice applies to construction sites operating under Part II.E.3. of the TPDES General Permit Number TXR150000 for discharges of storm water runoff from construction sites equal to or greater than five acres, including the larger common plan of development. The information on this notice is required in Part III.D.2. of the general permit. This notice shall be posted along with a copy of the signed Notice of Intent (NOI), as applicable. Additional information regarding the TCEQ storm water permit program may be found on the internet at: http://www.tceq.state.tx.usinav/permits/sw_permits.html