HomeMy WebLinkAboutNOIA
x ~ ~ T
December 13, 2010
Ali Jaffer
5727 Richmond Ave, APT. 202
Dallas, TX 75206
aliinksa@yahoo. com
7607 Eastmark Drive, Ste. 250-F <77840>
P.O. Box 9253, College Station, TX 77842
Off/Fax: (979) 764-0704
email: civil@rmengineer.com
RE: Randall's University Park, Lot 3R-2 - College Station, TX
TCEQ SWP3 & NOI Submittal Package
RME No. 220-0419
Ali Jaffer:
Please find attached two (2) copies (1 - 24x36 and I - 11x17) of the referenced SWPPP and two
(2) copies of its associated Construction Site Notice and NOI with one (1) copy of the Payment
Submittal Form. Please provide one full-size copy of the SWPPP, signed and completed
Construction Site Notice and NOI to the TCEQ as directed below and retain one copy of each for
your records.
Near the middle of page one of the NOI, please complete the area requesting the e-pay voucher
number or the check/money order number and name on the check/money order. The TCEQ
requires that the permit documents and the payment for the application fee be processed
separately. Application fees have increased to $225.00 for NOI's submitted on-line or $325.00
for mail-in forms. Both fees may be paid on-line at httos:Hww"6.tcea.state.tx.us/et)av/. Next,
proceed to Section E and sign where indicated for certification. (Please note: The individual
who signs in Section E must be authorized to sign for the permitted entity, according to 30
Texas Administrative Code 4305.44, and is considered the Site Operator who is solely liable
for all inspection reports and maintenance required by TCEQ, unless a Letter of Delegation
is issued to the Site Operator's Representative responsible for all inspection reports and
maintenance of the SWPPP). Submit the signed and completed NOI on-line per the
instructions given at http_://www6 tcetl_state tx__us,/steers/ or mail a signed copy of the NOI to:
Texas Commission on Environmental Quality
Storm Water Processing Center (MC228)
P.O. Box 13087
Austin, Texas 78711-3087
If mailing the payment for the application fees, complete the Payment Submittal Form as
directed, staple the check/money order for the $325.00 or $225.00 mail-in application fee where
indicated and mail to:
CD1-220-0419-L03.docx Page 1 of 2
S
i
Texas Commission on Environmental Quality
Financial Administration Division
Cashier's Office, MC-214
P.O. Box 13088
Austin, Texas 78711-3088
7607 Eastmark Drive, Ste. 250-F <77840>
P.O. Box 9253, College Station, TX 77842
Off/Fax: (979) 764-0704
email: civil@rmengineer.com
Finally, be sure to post a laminated copy of the half-sized SWPPP, signed NOI and Construction
Site Notice at the construction site, at a location visible from the Right-of-Way. Please note that
NOI's submitted on-line are valid immediately following submission and NOI's mailed to the
TCEQ are considered valid seven (7) days after postmarked. If you have questions regarding the
process for on-line payments or on-line submission of NOI's, please see the TCEQ website at
http_//Nvw,w.tcea..state.txAus/ or call the Storm Water Quality Division at (512) 239-4671.
Please contact us should you have any other questions.
Sincerely,
Rabon A. Metcalf, E. No. 88583
Texas Firm Registration No. F-4695
mbon(i,rmengineer.com
cc: City- of College Station
Planning & Development Services
1101 South Texas Avenue
College Station, TX 77845
CDI-220-0419-L03.docx Page 2 of 2
I
i
TCEQ Office Use Only
F"7 Notice of Intent (NOI) for Storm Water Permit No.: TXR15
Discharges Associated with Construction RN:
Activity under TPDES General Permit CN:
AIMIN
TCEQ (TXR150000) Ref No:
Sign up now for ePermits NOI at https://www6.teeci.state.tx.us/steers/
Get Instant Permit Coverage and only pay a $225 application fee.
~oseo°~°° If filing a paper NOI you can pay the application fee online? Gotohtips://www6.tceq.state.tx.us/epay/
Select Fee Tynee GENERAL PERMIT CONSTRUCTION STORM WATER DISCHARGE NOI APPLICATION
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?
F_jYes - What is your permit number? Permit No. TXR15
E]No - 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:
❑ 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 RegistrX)
2. What is the Legal Name of the entity (applicant) applying for this permit?
Ali Jaffer
(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: Ali Jaffer
Job Title: Owner
4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? (verify at USPS.com)
Address: 5727 Richmond Avenue, Apt 202
Suite No./Bldg. No./Mail Code:
City: Dallas
State: TX
ZIP Code: 75206
Country Mailing Information (if outside USA). Country Code: Postal Code:
5. Phone No.: ( 979) 202-1933
Extension:
6. Fax No.: ( >
E-mail Address: aliinksa@yahoo.com
7. Indicate the type of Customer:
Q Individual ❑Sole Proprietorship-D.B.A. ❑Limited Partnership
❑Corporation ❑Federal Government ❑General Partnership
❑ State Government ❑County Government ❑City Government
❑Other Government ❑Other (describe):
TCEQ-20022 (03/05/2008)
Page I
8. Independent Operator: ❑ Yes ❑No (If governmental entity, subsidiary, or part of a larger corporation, check "No".)
9. Number of Employees: [D0-20; ❑21-100; ❑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 (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: Rabon A. Metcalf, P.E.
Title: Owner
company: RME Consulting Engineers
2. Phone No.: ( 979 ) 764-0704
Extension:
3. Fax No.: 979 764-0704
E-mail Address: rabon@rmengineer.com
C. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE
1. TCEQ Issued RE Reference Number (RN): RN
(Search Central Regyistn.)
2. Name of Project or Site (the name as known by the community where this facility/project is located):
Randall's University Park, Lot 3R-2 - College Station, TX
(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 USPS.com or other delivery source)
Street Number:
Street Name: Chimney Full Drive
city: College Station, TX
ZIP Code: 77840
Section Bt 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
5. Latitude: N 30.63514
Longitude: W 96.33216
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) Residential Development
7. What is the mailing address for the regulated entity?
Is the RE mailing address the same as the Operator? Dyes, address is the same as Operator No, provide the address
Street Number:
Street Name:
City:
State:
ZIP Code:
D. GENERAL CHARACTERISTICS
1. Is the site located on Indian Country Lands? QNo ❑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.to%)
Primary: 1521 Secondary:
TCEQ-20022 (03/05/2008) Page 2
3(a) What is the total number of acres disturbed? 4.0 acres
3(b) Is the project site part of a larger common plan of development or sale? ❑Yes o
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. 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?
Burton Creek
4(b) What is the segment number(s) of the classified water body(s) that the discharge or potential discharge will eventually
reach? 1209L
4(c) Are any of the surface water bodies receiving discharges from the construction site on the latest EPA-approved C WA
303(d) list of impaired waters?
❑ Yes Q No
If Yes, provide the name of the impaired water bod s .
4(d) Is the discharge into an MS4? QYes ❑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?
❑ 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" tothe certifications below. Failure to certify to all items ivill result in denial.
Q
Yes
I certify that I have obtained a copy and understand the tetras and conditions of the general permit (TXR 150000).
ED 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.
0 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 Ali Jaffer Owner
Typed or printed name (Required & must be legible) 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 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 Teas .Odministrati% e Code 6305.44 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
r
CONSTRUCTION SITE NOTICE
FOR THE
Texas Commission on Environmental Quality (TCEQ)
Storm Water Program
TPDES GENERAL PERMIT TXR150000
The following information is posted in compliance with Part II.D.2. of the TCEQ General Permit Number
TXR150000 for discharges of storm water runoff from construction sites. Additional information regarding the
TCEQ storm water permit program may be found on the internet at:
http://www.tceq.state.tx.us/permitting/water quality/stormwater/TXR15 AIR.html
Contact Name and Phone Number:
Ali Jaffer
(979) 202-1933
Project Description:
Randall's University Park - Lot 311-2
5727 Richmond Ave, APT. 202
Dallas, TX 75206
(Physical address or description of the site's
location, estimated start date and projected end
On the north side of Chimney Hill Drive just west of its intersection
date, or date that disturbed soils will be
with Arguello Drive.
stabilized)
Estimated Start Date: 4/34111
Estimated End Date: 12/31111
Location of Storm Water Pollution
RME Consulting Engineers
7607 Eastmark Drive, Suite 25OF
Prevention Plan :
College Station, TX 77840
For Construction Sites Authorized Under Part II.D.2. (Obtaining Authorization to Discharge) the following
certification must be completed:
I Ali Jaffer (Typed or Printed Name Person Completing This Certification) Certify under penalty of
law that I have read and understand the eligibility requirements for claiming an authorization under Part 11.13.2. of
TPDES General Permit TXR150000 and agree to comply with the terms of this permit. A storm water pollution
prevention plan has been developed and implemented according to permit requirements. A copy of this signed
notice is supplied to the operator of the MS4 if discharges enter an MS4 system. I am aware there are significant
penalties for providing false information or for conducting unauthorized discharges, including the possibility of fine
and imprisonment for Icnewing..violations.
3 ( /G (
Signature and Title Date
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i N o o PAVING, DRAINAGE & UTILITY IMPROVEMENTS VA r A
COLLEGE STATION, BRAZOS COUNTY, TX
TCEQ Office Use Only
r ■ Notice of Intent (NOI) for Storm Water Permit No.: TXR15
Discharges Associated with Construction RN:
Activity under TPDES General Permit CN:
TCEQ (TXR150000) Ref No:
Sign up now for ePern its NOI at littps://www6.teeg.state.tx.tis/steers/
Get Instant Permit Coverage and only pay a $225 application fee.
Go to htt ~s:r~~ ~th.tcci .strtc.t~.us c rn /
If filing a paper NOI You can pay the application fee online?
1 i I
eoe°
,
Select Fee Tyneo GENERAL PERMITCONSTRUCTION STORM WATER DISCHARGF. NOI APPLICATION
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. TXRI5
El No - a permit number will be issued.
Application Fee if mailing a paper NOI:
You must pay the x;325 Application Fee to TCEQ for the application to be considered complete.
Payment and NO[ 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 (Search Central Re,_,istrN)
2. What is the Legal Name of the entity (applicant) applying for this permit?
Ali Jaffer
(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: Ali Jaffer
Job Title: Owner
4. What is the Operator's (applicant) mailing address as recognized by the US Postal Service? erir. at ISPS.com)
Address: 5727 Richmond Avenue, Apt 202
Suite No./Bldg. No-/Mail Code:
City: Dallas
State: TX
ZIP Code: 75206
Country Mailing Information (if outside USA). Country Code: Postal Code:
S. Phone No.., ( 979) 202-1933
Extension,
6. Fax No.: ( )
E-mail Address: aliinksa@yahoo.com
7. Indicate the type of Customer:
❑Individual ❑Sole Proprietorship-D.B.A. ❑Limited Partnership
❑Corporation ❑Federal Govetrunent ❑General Partnership
❑ State Government ❑County Government QCity Government
❑Other Government ❑Other (describe):
TCEQ-20022 (03/05/2008) Page I
8. Independent Operator: QYes []No (If governmental entity, subsidiary, or part of a larger corporation, check "No".)
9. Number of Employees: QO-20: 021-100; 0101-250: 0251-500; or 0501 or higher
10. Customer Business Tax and Filing Numbers (This item is not applicable to Individuals, Gavenvnent, GP or Sole Proprietor.)
REQUIRED for Corporations and Limited Partnerships (vcrifi the entitv's snrnrs and filing no. kith 1 X SOS at 512/163-5555 >
State Franchise Tax 11) 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: Rabon A. Metcalf, P.E.
Title: Owner
Company: RME Consulting Engineers
2. Phone No.: ( 979 ) 764-0704
Extension:
3. EaxNo.: 979 764-0704
E-mail Address: rabon@rmengineer.com
C. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE
1. TCEQ Issued RE Reference Number (RN): RN
(Search ('entral I%c~istrv)
2. Name of Proicct or Site (the name as known by the community where this facility/project is located):
Randall's University Park, Lot 3R-2 - College Station, TX
(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. (veritN it with I SPS.com or other dcliverv source)
Street Number:
Street Name: Chimney Hill Drive
city College Station, TX
ZIP Code: 77840
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
5. Latitude: N 30.63514
Longitude: W 96.33216
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) Residential Development
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 ❑No, provide the address
Street Number:
Street Name:
City:
State:
ZIP Code:
D. GENERAL CHARACTERISTICS
1. Is the site located on Indian Country Lands? r_,71 No ❑Yes - If Yes, do not submit this NOL Contact EPA, Region VI
If the site is on Indian count 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.~~_m
Primary: 1521 Secondary:
TCEQ-20022 (03/05/2008) Page 2
3(a) What is the total number of acres disturbed? 4.0 acres
3(b) Is the project site part of a larger common plan of development or sale? ❑Ycs No
If Yes, the total number of acres disturbed can be less than 5 acres.
the total number of acres disturbed must be 5 or more. If the total number of acres disturbed is less than 5 then the
I I'No
,
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. Discharge Information (all information INTLST 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?
Burton Creek
4(b) What is the segment number(s) of the classified water body(s) that the discharge or potential discharge will eventually
reach? 1209L
4(c) Are any of the surface water bodies receiving discharges from the construction site on the latest tiPA-approved C WA
303(d) list of impaired waters?
❑ Yes El No
I f Yes, provide the name of the impaired water body(s)
4(d) Is the discharge into an MS4? Elves ❑No
If Yes. what is the name of the MS4 Operator? City of College Station
Note: 1be 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 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. l'ailure to certirN to all items t1 ill result in dc-.=.ial.
0 Yes
1 certifv that I have obtained a copy and understand the terms and conditions of the general permit (TXR150000).
Q 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.
Q Yes
I understand that a Notice of Termination (NOT) must be submitted when this authorization is no longer needed.
Q Yes
1 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 perm it TXR150000.
Operator Certification:
Ali Jaff r Owner
Typed or printed name (r squired & wu,, J 1;,, legihlek 'fide (Pvq Tired ,s lcgif tc J
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 ant aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
I further certify that 1 am authorized under 30 I c~as %dniinistrativ€ Oxlc 3054-4 to sign and submit this document, and can provide documentation in
proof of such authorization upon request.
Signature: 1-- - Date: If ,f J= I IC-
(Use blue ink)
I'CGQ-20022 (03/05/2008) rage
e
I
ITYY11
'Wifiii
>r
CONSTRUCTION SITE NOTICE
FOR THE
Texas Commission on Environmental Quality (TCEQ)
Storm Water Program
TPDES GENERAL PERMIT TXR150000
The following information is posted in compliance with Part I1.D.2. of the TCEQ General Permit Number
TXR150000 for discharges of storm water runoff from construction sites. Additional information regarding the
TCEQ storm water permit program may be found on the internet at:
http://www.tceq.state.tx.us/permitting/",ater quality/stormwater/TXR15 A1R.html
Contact Name and Phone Number:
Ali Jaffer
(979) 202-1933
Project Description:
Randall's University Park - Lot 3R-2
5727 Richmond Ave, APT. 202
Dallas, TX 75208
(Physical address or description of the site's
location, estimated start date and projected end
On the north side of Chimney Hill Drive just west of its intersection
date, or date that disturbed soils will be
with Arguello Drive.
stabilized)
Estimated Start Date: 1/31/11
Estimated End Date: 12131/11
Location of Storm Water Pollution
Prevention Plan :
RME Consulting Engineers
76 Eastmark Drive, Suite 25OF
College station, TX 77840
For Construction Sites Authorized Under Part II.D.2. (Obtaining Authorization to Discharge) the following
certification must be completed:
I Ali Jaffer (Typed or Printed Name Person Completing This certification) certify under penalty of
law that I have read and understand the eligibility requirements for claiming an authorization under Part 11.13.2. of
TPDES General Permit TXR150000 and agree to comply with the terms of this permit. A storm water pollution
prevention plan has been developed and implemented according to permit requirements. A copy of this signed
notice is supplied to the operator of the MS4 if discharges enter an MS4 system. I am aware there are significant
penalties forproviding false information or for conducting unauthorized discharges, including the possibility of fine
and imprisonment for ations.
1( 1
S ignat n Title Date