CM-2019-0108 - 4/19/2019Agent Authorization Form
For Required Signature
Edwards Aquifer Protection Program
Relating to 30 TAC Chapter 213
Effective June 1, 1999
Laurie Hadley
Print Name
City Manager ,
Title - Owner/President/Other
Of City of Round Rock ,
Corporation/Partnership/Entity Name
have authorized Sean Mason
Print Name of Agent/Engineer
of Kimlev-Hom and Associates. Inc.
Print Name of Firm
to represent and act on the behalf of the above named Corporation, Partnership, or Entity for
the purpose of preparing and submitting this plan application to the Texas Commission on
Environmental Quality (TCEQ) for the review and approval consideration of regulated
activities.
1 also understand that:
1. The applicant is responsible for compliance with 30 Texas Administrative Code
Chapter 213 and any condition of the TCEQ's approval letter. The TCEQ is authorized
to assess administrative penalties of up to $10,000 per day per violation.
2. For those submitting an application who are not the property owner, but who have the
right to control and possess the property, additional authorization is required from the
owner.
3. Application fees are due and payable at the time the application is submitted. The
application fee must be sent to the TCEQ cashier or to the appropriate regional office.
The application will not be considered until the correct fee is received by the
commission.
4. A notarized copy of the Agent Authorization Form must be provided for the person
preparing the application, and this form must accompany the completed application.
5. No person shall commence any regulated activity on the Edwards Aquifer Recharge
Zone, Contributing Zone or Transition Zone until the appropriate application for the
activity has been filed with and approved by the Executive Director.
1W,,2L 4 '-v1�3
'TCEQ-0599 (Rev. 0410112010)
Page 1 of 2
SIGNATURE PAGE:
&Lli�u
Applicant's Signature
THE STATE OF Texas §
County of Williamson §
Date
BEFORE ME, the undersigned authority, on this day personally appearedL&!�ix known
to me to be the person whose name is subscribed to the foregoing instrument, and acknowl dged to
me that (s)he executed same for the purpose and consideration therein expressed.
GIVEN under my hand and seal of office on this _ay of a 1 aq
TARY FLqBLIC
Typed or Pririted Nanie of Notary
-A'`r oFTW�•' MY COMMISSION EXPIRES:
TCEO-0599 (Rev 0410112010) Page 2 of 2
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City of Round Rock
ROUTTEVN aacK Agenda Item Summary
TESD+
Agenda Number:
Title: Consider executing TCEQ "Agent Authorization Form For Required
Signature Edwards Aquifer Protection Program Relating to 30 TAC Chapter
213" authorizing Sean Mason to represent and act on behalf of the City
regarding the Lake Creek 10 Wastewater Improvements Project.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 4/19/2019
Dept Director: Michael Thane, Director of Utilities and Environmental Services
Cost: $650.00
Indexes: Self -Financed Wastewater Construction
Attachments: LAF, MAP, Agent Authorization Form
Department: Utilities and Environmental Services
Text of Legislative File CM -2019-0108
The City's Wastewater Master Plan identified the Lake Creek 10 wastewater line as needing to
be upsized to meet the needs for the buildout of the service area. The construction of a few
higher density developments has resulted in the need to upsize this section of line at this time.
The Lake Creek 10 wastewater line improvements will upsize approximately 1,400 linear feet of
existing 10 -inch wastewater line to either a 12 -inch or 15 -inch diameter wastewater main.
The City of Round Rock is required by the Texas Commission on Environmental Quality
(TCEQ) to obtain an Organized Sewer Collection System (SCS) approval from TCEQ prior to
conducting work over the Edwards Aquifer Recharge Zone (EARZ). The Lake Creek 10
Wastewater Improvements Project is located over the EARZ and as a result, the City must
address the EARZ requirements. By the City executing the Agent Authorization form, this will
authorize the City's consultant, Mr. Sean Mason of Kimley-Horn and Associates, Inc., to act as
an agent to the City and submit the application for approval of the SCS for this project.
The Utility staff recommend execution of the TCEQ Agent Authorization form.
Cost. $650
Source of Funds: Self -Financed Wastewater Construction
City cf Round Rock Page t Painted on 41M019