CM-2017-1451 - 7/28/2017TCEQ Office Use Only
F"!Notice of Termination (NOT) permit No.:
for Authorizations under RN:
TPDES General Permit TXR150000 CN:
TCECQ
Sign up now for on line NOT at httg://www.tceci.state.tx.us/permittinz/steers/steers.htmi
Get your NOT Confirmation letter immediately after submitting the on line NOT form.
What is the permit number to be terminated?
Processing will be delayed without the permit number. TXR150022278
A. OPERATOR (applicant)
1. What is the Customer Number (CN) issued to this entity? CN 600413181
2. What is the full Legal Name of the current permittee?
City of Round Rock
This must be the current pemduce of the pennit to be terminated.
3. What is theapplicant's mailing address as recognized by the US Postal Service?
Address: 221 E. Main Street I Suite No./Bldg. No./Mail Code:
City: Round frock State: Texas I ZIP Code: 78664
Country Mailing Information if outside USA). Count Code: Postal Code:
4. Phone No.: 512 218-5401 Extension:
5. Fax No.: E-mail Address: Ihadley@roundrocktexas.gov
B. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE
I . What is the TCEQ Issued RE Reference Number (RN)? RN 108886870
2. Name of Project or Site as currently permitted):
Lake Creek 2 & Lake Creek 3 Wastewater Line Upgrades
(example: phase and name of subdivision or name of project that's unique to the site
3. Physical Address of Project or Site as currently permitted: (enter in spaces below)
Street Number: I Street Name:
City: ZIP Code: County (Counties if > 1):
4. If no physical address (Street Number & Street Name), provide the written location access description to the site:
This site Is located near Lake Creek Park at the intersection of Deerfoot Drive and Dove Haven Drive
C. REASON FOR TERMINATION
Check the reason for termination:
0 Final stabilization has been achieved on all portions of the site that are the responsibility of the Operator and all silt fences and other
temporary erosion controls have either been removed, or scheduled for removal as defined in the SWP3.
El Another permitted Operator has assumed control over all areas of the site that have not been finally stabilized, and temporary
erosion controls that have been defined in the SWP3 have been transferred to the new Operator.
❑ The activity is now authorized under an alternate TPDES permit.
LJ The activity never began at this site that is regulated under the general permit.
D. CERTIFICATION
I Lau&'Ha Aey c.I y4 -v4 LA -)f +♦ 1)*tK6 741!5;r_ City Manager
Typed or printed name #Title
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 passibility of fine and imprisonment for
knowing violations.
1 further certify that I am authorized under 30 Texas Administrative Code §305.44 to sign and submit this document, and can provide documentation in
proof of sac onzation upon request.
Signature: '' �s[� Date:.
(Use blue ink)
TCEQ-20023 (02106;2007) Page 1
011- 2 of 7-14
Notice of Termination (NOT) for Authorizations under
TPDES General Permit TXR150000
General Information and Instructions
GENERAL INFORMATION
Where to Send the Notice of Intent (NO[):
BY REGULAR U.S. MAIL BY OVERNIGHT EXPRESS MAIL
Texas Commission on Environmental Quality Texas Commission on Environmental Quality
Storm Water Processing Center (MC228) Storm Water Processing Center (MC228)
P.O. Box 13087 12100 Park 35 Circle
Austin, TX 78711-3087 Austin, TX 78753
TCEQ Contact list:
Application Processing Questions relating to the status and form requirements: 51212394671
Technical Questions relating to the general permit: 512/2394671
Environmental Law Division: 5 12; 239-0600
Records Management for obtaining copies of fors submitted to TCEQ: 512!239-0900
Information Services for obtaining reports from program data bases (as available): 512/239 -DATA (3282)
Financial Administration's Cashier's office: 512/239-0357 or 51 2J239-0187
Notice of Termination Process:
A Notice of Termination is effective on the date postmarked for delivery to TCEQ.
When your NOT is received by the program, the for will be processed as follows:
I. Administrative Review: The for will be reviewed to confirm the following:
• the permit number is provided
• the permit is active and has been approved
• the entity terminating the permit is the current permittee
• the site information matches the original permit record
• the for has the required original signature with title and date
2, Notice of Deficiency: If an item is incomplete or not verifiable as indicated above, a phone call will be made to the applicant to clear the deficiency.
A letter will not be sent to the permittee if unable to process the form.
3. Confirmation of Termination: A Notice of Termination Confirmation letter will be mailed to the operator.
General Permit (Your Permit)
Coverage under the general permit begins 48 hours after a completed NOI is postmarked for delivery to the TCEQ. You should have a copy of your
general permit when submitting your application. You may view and print your permit for which you arc seeking coverage, on the TCEQ web site
www.tcc .state.tx.us
General Permit Forms
The Notice of Intent (NOI), Notice of Termination (NOT), and Notice of Change (NOC) with instructions are available in Adobe Acrobat
PDF format on the TCEQ web site www,tcc .state.tx.us.
Change in Operator
An authorization under the general permit is not transferable. If the operator or owner of the regulated entity changes, the present permittee must submit
a Notice of Termination and the new operator must submit a Notice of Intent. The NOT and NOI must be submitted not later than 10 days prior to the
change in Operator status.
TCEQ Central Registry Core Data Form
The Core Data Farm has been incorporated into this farm. Do not send a core data form to TCEQ.
After final acknowledgment of coverage under the general permit, the program will assign a Customer Number (CN) and Regulated Entity Number (RN)
For Construction Permits, a new RN will be assigned for each Notice of Intent filed with TCEQ, since construction project sites can overlap with other
Customers. The RN assigned to your construction project will not be assigned to any other TCEQ authorization.
You can find the information on the Central Registry web site at www4.tcea.statc.tx.uslcrpub. You can search by the Regulated Entity (RN), Customer
Number (CN) or Name (Permittee), or by your permit number under the search field labeled "Additional ID". Capitalize all letters in the permit number.
TCEQ-20023 Instructions (02106/2007) Page I
The Customer (Permittee) is responsible for providing consistent information to the TCEQ, and for updating all CN and RN data for all authorcations as
changes occur. For General Permits, a Notice of Change form must be submitted to the program area.
Annual Nater Quality Fee: This fee is assessed to operators with an active authorization under the general permit on September 1 of each year. The
operator will receive an invoice for payment of the annual fee in November of each year. The payment will be due 30 days from the invoice date. A 5%
penalty will be assessed if the payment is received by TCEQ after the due date. Annual fee assessments cannot be waived as long as the authorization
under the general permit is active on September I.
It's important for the operator to submit a Notice or Termination (NOT) when coverage under the general permit is no longer required. A NOT is
effective on the postmarked date of mailing the form to TCEQ. It is recommended that the NOT be mailed using a method that documents the date
mailed and received by TCEQ.
• Mailed Payments.
You must return your payment with the billing coupon provided with the billing statement.
• cPAY Electronic Payment
Go to www.tcca.statc.tx.uslenay
You must enter your account number provided at the top portion of your billing statement. Payment methods include Mastercard, Visa, and electronic
check payment (ACH). A transaction over 5500 can only be made by ACH.
INSTRUCTIONS FOR FILLING OUT THE NOT FORM
A. OPERATOR currentpermittee.)
1. TCEQ Issued Customer Number (CN)
2. Legal Name of Operator
Theoperator must be the same entity as previously submitted on the original Notice of Intent for the perTnit number provided.
3. Operator Mailing Address
Provide a complete mailing address for receiving mail from the TCEQ. Update the address if different than previously submitted in the Notice of Intent
or Notice of Change.
4. Phone Number, Fax Number, and E-mail Address
Provide updated contact information.
B. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE
1. Regulated Entity Reference Number (RN)
2. Site/Project Name/Regulated Entity
Provide the name of the site as ereviously submitted in the Notice of Intent for the permit number provided.
3. Site/Project (RE) Physical Address
Provide the physical address or location access description as previously submitted for the permit number provided.
C. REASON FOR TERMINATION
Indicate the reason for terminating the permit by checking one of the options. If the reason is not listed then provide an attachment that explains the
reason for termination.
Please read your general permit carefully to determine when to terminate your permit. Permits will not be reactivated after submitting a termination form.
The termination is effective on the date postmarked for delivery to TCEQ.
D. CERTIFICATIONS
The certification must bear an original signature of a person meeting the signatory requirements specified under 30 Texas Administrative Code (TAC)
§305.44.
IF YOU ARE A CORPORATION:
The regulation that controls who may sign an NOI or similar form is 30 Texas Administrative Code §305.44(x)(1) (see below). According to
this code provision, any corporate representative may sign an NOI or similar form so long as the authority to sign such a document has been delegated to
that person in accordance with corporate procedures. By signing the NOI or similar form, you are certifying that such authority has been delegated to
you. The TCEQ may request documentation evidencing such authority.
IF YOU ARE A MUNICIPALITY OR OTHER GOVERNMENT ENTITY:
The regulation that controls who may sign an NOI or similar form is 30 Texas Administrative Code §305.44(x)(3) (see below). According to
this code provision, only a ranking elected official or principal executive officer may sign an NO[ or similar form. Persons such as the City Mayor or
County Commissioner will be considered ranking elected officials. In order to identify the principal executive officer of your government entity, it may
be beneficial to consult your city charter, county or city ordinances, or the Texas statute(s) under which your government entity was formed. An NOI or
similar document that is signed by a government official who is not a ranking elected official or 2rincipal executive officer does not conform to
TCEQ-20023 Instructions (02106/2007) Page 2
§305.44(a)(3). The signatory requirement may not be delegated to a government representative other than those identified in the regulation. By signing
the NOI or similar form, you are certifying that you are either a ranking elected official or principal executive officer as required by the administrative
code. Documentation demonstrating your position as a ranking elected official or principal executive officer may be requested by the TCEQ.
If you have any questions or need additional information concerning the signatory requirements discussed above, please contact the Texas Commission
on Environmental Quality's Environmental Law Division at 512/239-0600.
30 Texas Administrative Code
§305.44. Signatories to Applications.
(a) All applications shall be signed as follows.
(1) For a corporation, the application shall be signed by a responsible corporate officer. For purposes of this paragraph, a responsible
corporate officer means a president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or any other
person who performs similar policy or decision-making functions for the corporation; or the manager of one or more manufacturing, production, or
operating facilities employing more than 250 persons or having gross annual sales or expenditures exceeding 525 million (in second-quarter 1980
dollars), if authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures. Corporate procedures
governing authority to sign permit or post -closure order applications may provide for assignment or delegation to applicable corporate positions rather
than to specific individuals.
(2) For a partnership or sole proprietorship, the application shall be signed by a general partner or the proprietor, respectively.
(3) For a municipality, state, federal, or other public agency, the application shall be signed by either a principal executive officer or a
ranking elected official. For purposes of this paragraph, a principal executive officer of a federal agency includes the chief executive officer of the
agency, or a senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency (e.g., regional
administrator of the EPA).
TCEQ-20023 Instructions (02:'06:'2007) 1}a13e 3
City of Round Rock
T TZ
aaAsa ROC Agenda Item Summary
Agenda Number:
Title: Consider executing Notice of Termination (NOT) for Authorization under
TPDES General Permit (TCR150000) regarding the Lake Creek 2 & Lake
Creek 3 Wastewater Line Upgrade Project.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 7/28/2017
Dept Director: Michael Thane, Director of Utilities and Environmental Services
Cost:
Indexes:
Attachments: Notice of Termination 7-18-17.pdf, LAF - TCEQ Notice of Termination -
Lake Creek 2 Lake Creek 3 WW Line Upgrade Project
(00382690xA08F8). pdf
Department: Utilities and Environmental Services
Text of Legislative File CM -2017-1451
Consider executing Notice of Termination (NOT) for Authorization under TPDES
General Permit (TCR150000) regarding the Lake Creek 2 & Lake Creek 3 Wastewater
Line Upgrade Project.
Consider executing a Notice of Termination (NOT) for Stormwater Discharges
associated with construction activity under TPDES General Permit (TXR150000)
regarding the Lake Creek 2 and Lake Creek 3 Wastewater Line Upgrade Project. To
maintain compliance with State and Federal Laws and Regulations, the City must
comply with the requirements of the State's General MS4 Permit and the City's MS4
Permit. The City of Round Rock is required by the Texas Commission on
Environmental Quality (TCEQ) to submit a NOT upon completion of the construction
project.
Staff recommends approval.
City o! Round Rock Page 7 Printed on 7/27/7017