CM-2015-868 - 8/21/2015_1
Agent Authorization Form
For Required Signature
Edwards Aquifer Protection Program
Relating to 30 TAC Chapter 213
Effective June 1, 1999
e
City Manager
of City of Round Rock
Corporation/Partnership/Entity Name
have authorized Brian Rice, P.E.
Print Name of Agent/Engineer
Of Binkley & Barfield, 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.
I 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.
TCEQ-0599 (Rev.04/01/2010)
(?A4- D -b (?6 (?
Page 1 of 2
SIGNATURE PAGE:
z
Applicant's Signature
THE STATE OF Texas §
V tg
County of §
Date
0
BEFORE ME, the undersigned authority, on this day personally appeared j5r( f) De(CIP-) known
to me' to be the person whose name is subscribed to the foregoing instrument, and acknowledged to
me that (s)he executed same for the purpose and consideration therein expressed.
GIVEN under my hand and seal of office on this ,jq4" flay ofAU U6+
Kim 10 1 "M JL)�e�avkj
NOTARY PUBLIC
Leg 116 rl(-k e.h enn
Typed or Printed Name of Notary
MY COMMISSION EXPIRES: ()I- ograylg
TCEO-0599 (Rev.04/01/2010)
Page 2 of 2
City of Round Rock
ROUND ROCK
TEXAS Agenda Item Summary
Agenda Number:
Title: Consider executing TCEQ "Agent Authorization Form For Required
Signature Edwards Aquifer Protection Program Relating to 30 TAC
Chapter 213" authorizing Brian Rice to represent and act on behalf of the
City regarding the Sports Center Wastewater Line Improvements Project.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 8/21/2015
Dept Director: Michael Thane, Director of Utilities and Environmental Services
Cost:
Indexes:
Attachments: LAF - TCEQ Edwards Aquifer Protection Program - Sports Center WW
Line (00340612xA08F8).pdf, Binkley Barfield Agent Auth Form.pdf
Department: Utilities and Environmental Services
Text of Legislative File CM -2015-868
Consider executing TCEQ "Agent Authorization Form For Required Signature Edwards
Aquifer Protection Program Relating to 30 TAC Chapter 213" authorizing Brian Rice to
represent and act on behalf of the City regarding the Sports Center Wastewater Line
Improvements Project.
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
F.M. 3406 -Sports Center Wastewater Line Improvement 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, Brian
Rice, P.E. of Binkley & Barfield, Inc., to act as an agent to the City and submit the
application for approval of the SCS for this project.
Staff recommends approval.
City of Round Rock Page 1 Printed on 8/2112015