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Home My WebLink AboutNOI r - R TCEQ Office Use Only Notice of Intent (NOI) for Storm Water PermitNo.: TXR15 Discharges Associated with Construction RN: `' Activity under TPDES General Permit CN: TCEQ (TXR150000) Ref No: Sign up now for ePerrrtits NOI at www6.lcecl.state.tx.us /steers Get Instant Permit Coverage and only pay a S225 application fee. If filing a paper NOI you can pay the application fee on line? Go to wwu.tceq.state.tx.us /epav Select Fee Type: GENERAL PERMIT CONSTRUCTION STORM WATER DISCHARGE NOI APPLICATION I f submitting a paper 'N01, coverage under the general permit starts seven (7) days after the date postmarked for delivery to TCEQ. IMPORTANT: •Use the INSTRUCTIONS to fill out each question in this form. •Use the attached CUSTOMER CHECKLIST to make certain all ou filled out all required information. Y q •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 MiNo - a permit number will be issued. Application Fee if mailing a paper NOI: You must pay the S325 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: El 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 603253170 (Search Central Registry) 2. What is the Legal Name of the entity (applicant) applying for this permit? Whataburger Restaurants, 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: Bill Sorrells Job Title: Manager Engineering Design 4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? (veritt at ITSPS.com) Address: 300 Concord Plaza Drive Suite No. /Bldg. No. /Mail Code: City: San Antonio State:TX ZIP Code: 78216 Country Mailing Information (if outside USA). Country Code: Postal Code: 5. Phone No.: (210 ) 476 -6000 Extension: 6616 6. Fax No.: (210 ) 476 -6973 E -mail Address: bsorrells@wbhq.com 7. Indicate the type of Customer: ❑ Individual OSole Proprietorship- D.B.A. 0 Limited Partnership Corporation 0Federal Government General Partnership State Government ❑County Government City Government Other Government ❑Other (describe): TCEQ -20022 (03/05/2008) Page 1 1 8. Independent Operator: ® Yes El No (If governmental entity, subsidiary, or part of a larger corporation, check "No ".) 9. Number of Employees: 00 -20; 021 -100; 0101 -250; p 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 ( Verifs the entity's status and filing no. with TX SOS at 512/463 -5555 ) State Franchise Tax ID Number: 32029266908 Federal Tax ID: 741693771 TX SOS Charter (filing) Number: 800705649 DUNS Number (if known): B. APPLICATION CONTACT If TCEQ needs additional information regarding this application, who should be contacted? 1. Name: Bill Sorrells Title: Manager Engineer Design Company: Whataburger Restaurants 2. Phone No.: ( 210 ) 476 -6000 Extension: 6616 3. Fax No.: 210 476 -6973 E -mail Address: bsorrells@wbhq.com 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 name as known by the community where this facility /project is located): Whataburger- Spring Creek Commons (Lot 4, Block 1) Located at NWC of SH6 and William Fitch Parkway (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 See#ion A for a physical address. If No complete *WOO for site location information. Section A11 Enter the physical address for the site (verity it with t'SPS.corn or other dch% source) Street Number: Street Name: City: ZIP Code: Section. Ri 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: College Station 77842 4. Identify the county where the site is located: Brazos 5. Latitude: 30.578347 Longitude: _96.279906 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 : Commercial Quick Serve Restaurant 7. What is the mailing address for the regulated entity? Is the RE mailing address the same as the Operator? ® Yes, address is the same as Operator O No, provide the address Street Number: Street Name: City: State: ZIP Code: D. GENERAL CHARACTERISTICS 1. Is the site located on Indian Country Lands? ri 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 Os h a.gov) Primary: 2011 Secondary: TCEQ -20022 (03/05/2008) Page 2 3(a) What is the total number of acres disturbed? 0.97 Acres 3(b) Is the project site part of a larger common plan of development or sale? MI Yes ONo 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. Di h Inforaaa r 11) R on 511 ... or, the Permit t":41,1194011,', 7 "r yq , td ;p 1"; 4(a) What is the name of the water body(s) to receive the storm water runoff or potential runoff from the site? Spring Creek 4(b) What is the segment number(s) of the classified water body(s) that the discharge or potential discharge will eventually reach? Narasota River (Segment 1209) 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? El Yes ® No If Yes, provide the name of the impaired water body(s). 4(d) Is the discharge into an MS4? ® Yes El 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? Ej Yes Q 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 vi ill result in denial. ❑ Yes I certify that I have obtained a copy and understand the terms and conditions of the general permit (TXR 150000). 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. ri Yes I understand that a Notice of Termination (NOT) must be submitted when this authorization is no longer needed. r i 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. Operator Certification: I , Typed or printed name (Required rrnr■t he legible) Title (Rtrquir ell S. 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 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 5305. -14 to sign and submit this document, and can provide documentation in proof of such authorization upon request. Signature: Date:_ (Use blue ink) TCEQ -20022 (03/05/2008) Page 3