CM-08-01-023DATE: January 18, 2008
SUBJECT: City Manager - January 25, 2008
ITEM: Action authorizing the City Manager to execute a Notice of Intention
(NOI) with the Texas Commission on Environmental Quality (TCEQ)
General Storm Water Permits Division for RM 1431 36 -Inch Water
Line Improvements Project.
Department: Water and Wastewater Utilities
Staff Person: Michael D. Thane, P.E., Director of Utilities
Justification:
TCEQ requires that a NOI be filed by the City of Round Rock (CORR) for any construction
project disturbing an area of five (5) or more acres. Since the estimated amount of
disturbed area for this project is 7.5 acres, a NOI is required.
Funding:
Cost: $100.00
Source of funds: Capital Project Funds (Self -Financed Utility)
Outside Resources: K. Friese & Associates, Inc.
Background Information:
This project is identified in our current Water Master Plan and is necessary to provide a
maximum of four million gallons per day (mgd) of interim water and later emergency water
to the City of Cedar Park. Water will be provided in accordance with two Interlocal
Agreements, between the City of Round Rock and the City of Cedar Park, one for interim
water supply and one for emergency water supply.
Public Comment: N/A
Blue Sheet Format
Updated 01/20/04
TCEQ
Notice of Intent (NOI) for Storm Water
Discharges Associated with Construction
Activity under the TPDES General Permit
TCEQ Office Use Only
TPDES Permit Number: TXR151_1_1_1_I
GIN Number: 1 1 1 11 I1 I
Fee Receipt No.
IMPORTANT:
•Use the attached INSTRUCTIONS when completing this form.
•After completing this form, use the attached CUSTOMER CHECKLIST to make certain all items are complete and accurate.
•Missing, illegible, or inaccurate items may delay final acknowledgment or coverage under the general permit.
Application Fee: You must submit the $100 NOI Application Fee to TCEQ under separate cover (see instructions) using the attached Application Fee
submittal form. (DO NOT SEND A COPY OF THE NOI WITH THE APPLICATION FEE SUBMITTAL FORM)
Tell us how you paid for this fee:
Check/Money Order No.:
Name Printed on Check:
A. OPERATOR
1. TCEQ Issued Customer Number (CN) (if available): CN600413181
2. Legal Name (spelled exactly as filed with the Texas Secretary of State, County, or legal document that was used in forming the entity):
City of Round Rock
3. Mailing Address: 221 East Main Street
Suite No./Bldg.No.:
City: Round Rock
State: TX
ZIP Code: 78664
4. Phone No.: ( 512 ) 218 - 5400
Extension:
5. FAX No.
E-mail Address:
6. Type of Operator: 0 Individual 0 Sole Proprietorship-D.B.A. 0 Partnership
0 Corporation 0 Federal Government 0 State Government
0 County Government El City Government 0 Other:
7. Independent Operator: 0 Yes DNo (If governmental entity or a subsidiary or part of a larger corporation, check "NO")
8. Number of Employees: 0 0-20; [ 21-100; 0 101-250; 0 251-500; or El 501 or higher
9. Business Tax and Filing Numbers (not applicable to Individuals Government, General Partnerships, and Sole Proprietorship-D.BA):
State Franchise Tax ID Number. Federal Tax ID:
TX SOS Charter (filing) Number. DUNS Number (If known)
B. BILLING ADDRESS (The Operator is responsible for paying the annual fee.)
❑✓ Same As Operator (check if address is the same, then proceed with Section C.)
1. Billing Mailing Address:
Suite No.Bldg.No.:
City:
State:
ZIP Code:
2. Billing Contact (Attn or C/O):
3. Country Mailing Information (if outside USA) Territory:
Country Code: Postal Code:
4. Phone No.:
Extension:
5. FAX No.
E-mail Address:
TCEQ-20022 (07/12/2004)
Page 1 of 3
C. APPLICATION CONTACT (If TCEQ needs additional information regarding this application, who should be contacted?
1. Name: Don Rundell, P.E.
Title: Cheif Utility Engineer Company: City of Round Rock
2. Phone No.: ( 512 ) 218 - 5554
Extension: None
3. FAX No. (512) 218 - 3242
E-mail Address: drundell@round-rock.tx.us
D. REGULATED ENTYPY (RE) INFORMATION ON PROJECT OR SITE
1. TCEQ Issued RE Reference Number (RN) (if available):
2. Name of Project or Site: Cedar Park - Round Rock Interconnect
3. Physical Address of Project or Site: (enter in spaces below)
Street Number.
Street Name: No Address
City (nearest to the site):
Round Rock
ZIP Code (nearest to the site):
78728
County (Counties if >1):
Williamson
4. If no physical address (Street Number & Street Name), provide a written location access description that can be used for locating the site:
(Ex.: 2 miles west from intersection of Hwy 290 & IH35 on Hwy 290 South)
Along RM 1431 on north side of street for approximately 1,300 feet west of the intersection with Sam Bass Rd.,
along RM 1431 on south side for approximately 4,800 feet east of intersection with Sam Bass Road
5. Latitude: 30 32' 42" N Longitude: 97 45' 21" W
6. Standard Industrial Classification (SIC) code: 1623
7. Describe the activity related to the need for this authorization at this site (do not repeat the SIC andNAICS code):
Construction of water line to interconnect Cedar Park and Round Rock water systems
8. Is the project/site located on Indian Country Lands? El Yes in No
If Yes, you must obtain authorization through EPA, Region VI.
E. SITE MAILING ADDRESS (address for receiving mail at the site)
0 Same As Operator (check if address is the same, then proceed with Section F.)
Mailing Address:
City:
IState:
Suite No./Bldg.No.:
IZIP Code:
F. GENERAL CHARACTERISTICS
1. Has a Pollution Prevention Plan been prepared as required in the general permit? El Yes DNo
If No, coverage may be denied as the PPP is required at the time the NOI is submitted to TCEQ.
2. Provide the estimated area of land disturbed (to the nearest acre):
7.5 Acres
3. Provide the name of the receiving water body (local stream, lake, drainage ditch), MS4 Operator (if applicable) and the segment number where storm
water runoff will flow from the construction site.
MS4 Operator: Receiving Water Body: Brushy Creek
Segment
TCEQ-20022 (07/12/2004)
Page 2 of 3
NI -0k- O1o)3
CERTIFICATION
Thjne yy��r��j tt . Nit e
Typed or printed name
C:rki Maxer
Title (Require
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 §305.44 to sign and submit this document, and can provide documentation
in proof of spch authorization upon request.
Signature:
se Blue Ink)
Date:
TCEQ-20022 (07/12/2004)
Page 3 of 3