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CM-08-04-112DATE: SUBJECT: ITEM: April 21, 2008 City Manager - April 25, 2008 Action authorizing the City Manager to execute a Notice of Termination (NOT) to the Texas Commission on Environmental Quality (TCEQ) for stormwater discharge associated with construction of the McNutt Creek Wastewater Interceptor - Phase I. Deoartment: Staff Person: justification: Water & Wastewater Utilities Michael Thane, P.E., Water & Wastewater Utility Director The NOT is needed to notify the TCEQ that the construction activity for the McNutt Creek Wastewater Interceptor - Phase I has been completed. Funding: Cost: $0.00 Source of funds: Not Applicable Outside Resources: K. Friese & Associates Mole-Kassouf, J.V. Background Information: This project included the construction of 8,340 linear feet of 48" wastewater line which extends from the existing Brushy Creek Regional Wastewater Plant, located on the eastern side of the City of Round Rock, to a certain point on McNutt Creek. Public Comment: N/A VII Notice of Termination (NOT) TCEQ Office Use Only Permit No.: for Authorizations under RN: MOM MW TPDES General Permit TXR150000 CN: TCEQ Sign up now for on line NOT at http://www.tceo.state.tx.us/permitting/steers/steers.html 141 Get your NOT Coniumation 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. TXR15 CH01 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? The City of Round Rock This must he the current permittee of the permit to he terminated. 3. What is the applicant's mailing address as recognized by the US Postal Service? Address: 2008 Enterprise Drive Suite No.Bldg. No./Mail Code: NA City: Round Rock State: Texas ZIP Code: 78664 Country Mailing Information (if outside USA). Country Code: NA Postal Code: NA 4. Phone No.: ( 512 ) 341-3236 Extension: NA 5. Fax No.: ( 512 ) 218-3242 E-mail Address: mthane@round-rock.tx.us B. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE 1. What is the TCEQ Issued RE Reference Number (RN)? RN 2. Name of Project or Site as currently permitted): McNutt Creek Wastewater Interceptor - Phase! (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: NA Street Name: NA City: NA ZIP Code: NA County (Counties if>1): NA 4. If no physical address (Street Number & Street Name), provide the written location access description to the site: Intersection of County Road 122 & US Highway 79 C. REASON FOR TERMINATION Check the reason for termination: that are the responsibility of the Operator and all silt fences and other for removal as defined in the SWP3. of the site that have not been finally stabilized, and temporary transferred to the new Operator. general permit. 1 Final stabilization has been achieved on all portions of the site temporary erosion controls have either been removed, or scheduled ❑ Another permitted Operator has assumed control over all areas erosion controls that have been defined in the SWP3 have been ❑ The activity is now authorized under an alternate TPDES permit ❑ The activity never began at this site that is regulated under the D. CERTIFICAT ON I, James R. Nuse ` City Manager ped or printed na certify under penalty . that this docum: 4 . • 4 all attachments were prepared under my direction or to assure that qualified onnel properly gather and evaluate the information submitted. Based on my system, or those persons directly responsible for gathering the information, the information submitted is, accurate, and complete. I am aware there are significant penalties for submitting false information, including knowing violations. I further certify that I am authorized under 30 Texas Administrative Code §305.44 to sign and submit this proof of s h authorization upon request. Signature: Date: Title supervision in accordance with a system designed inquiry of the person or persons who manage the to the best of my knowledge and belief, true, the possibility of fine and imprisonment for document, and can provide documentation in h (� — aC)— 0 v (Use blue ink) TCEQ-2003 jA2/06/2007) Page 1 0 E-4 Z to ,so vi 3 iii b i 3 .V) ( 8 o ro a- ai .5 a) N .0 "C7 -. o En ^ N ca Q Y a. a) 'O lJ N a+ Tti 41 a E o a>co o m• O rUww ..a.,� � E. ocs, O C °y' ° ?aY 4- o o «f �_, d0�U c� o W �' o 0 ° W�� en o a) o ti-. .° 3 .-�Z0 � pA ,O 0 0 0 v OWZ 0 M a) 0_ _ 03 cn k.DQ C y o O CI .U O V O a 0� N g x Q a o- O; S ° 74 _ tr)> 0. ' 0 ,A o R. • O 2 ^al o. ' E- ` ca o o ami O �'' F W 3 0 ,, ;r o E , a) ;a •:c, o ,� co o W N y O a+ 0 0 i= "o U ID y a) M ti 1• p ^ci " O w g .!� m O U . to O a) 'O" o cC Z •' O rj 'o •o - ° G H O N 0 a) Q _ a) a0i O 2. a ti 0 S J, oo..) a•a.ai w �3 �-o o', ; 1 - cc) a 3 O 0 ... 0 vi CO" CO V(1)iwd Y Na0 O y G • q W 0 N .5_ p .0 w z �.O Q < vi I-, a + v U o o b ^ +� yam, g p' . r _ o O N Y o z < D C) alOV cn LI I ' ai O E C Y� O P 0 3 0 jt- a o 3 E� � . o oU =' a)'o 4-' 0 'o ca 0 �H ° 7 UZU 0 0 . UOO tip OF_ZOY tiy co O�� _ Ti vi �� Uaa) OO d'gZz. -,wowQ�a. }' a .d <—o D En 0 ov aU��ZHE-+ A E-. essoRommoo stir UZI woad 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_1 GIN Number. 11 1 1 1 1 11 - 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.: A. OPERATOR Name Printed on Check: 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: 2008 Enterprise Drive Suite No.BldgNo.: City: Round Rock State: Texas ZIP Code: 78664 4. Phone No.: ( 512 ) 218 - 5555 Extension: 5. FAX No. (512 ) 218 - 5563 E-mail Address: mthane@ci.round-rock.tx.us 6. Type of Operator: 0 Individual 0 Sole Proprietorship-D.B.A. ® Partnership 0 Corporation 0 Federal Government E3 State Government 0 County Government t City Government ®Other: 7. Independent Operator: 0 Yes 0 No (If governmental entity or a subsidiary or part of a larger corporation, check "NO") 8. Number of Employees: 0 0-20; 0 21-100; ® 10I-250; 0 251-500; or l 501 or higher 9. Business Tax and Filing Numbers (not applicable to Individuals, Government, General Partnerships, and Sole Proprietorship-D.B.A): 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.) 0 Same As Operator (check if address is the same, then proceed with Section C.) 1. Billing Mailing Address: Suite NoiBldg.No.: City: State: ZIP Code: 2. Billing Contact (Attn or C/0): 3. Country Mailing Information (if outside USA) Territory: Country Code: Postal Code: 4. Phone No.: ( ) Extension: TCEQ-20022 (07/12/2004) !i 31/1 CI 1 C Page 1 of 3 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: McNutt and Chandler Creeks Segment 8ren 1. Has a Pollution Prevention Plan been prepared as required in the general permit? Yes El No If No, coverage may be denied as the PPP is required at the time the NOI is submitted to TCEQ. 3. Physical Address of Project or Site: (enter in spaces below) 1. TCEQ Issued RE Reference Number (RN) (if available): E-mail Address: towens@kfriese.com 1. Name: Tom Owens, P.E. Title: Vice President Company: K Friese & Associates, Inc. C. APPLICATION CONTACT (If TCEQ needs additional information regarding this application, who should be contacted? 2. Phone No.: ( 512 ) 338 - 1704 3. FAX No. (512 ) 338- 1784 Extension: D. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE 2. Name of Project or Site: McNutt Creek Wastewater Interceptor- Phase Street Number: Street Name: HWY 79 City (nearest to the site): Round Rock ZIP Code (nearest to the site): 78664 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) Intersection of County Round 122 and US Hwy 79 5. Latitude: 30^ 32' 03" N Longitude: 97^ 36' 30" W 6. Standard Industrial Classification (SIC) code: 1623- Water, Sewer, Pipeline, and Communications and Power Line Construction 7. Describe the activity related to the need for this authorization at this site (do not repeat the SIC and NAICS code): Construction of a New Sanitary Sewer Main 8. Is the project/site located on Indian Country Lands? 0 Yes If Yes, you must obtain authorization through EPA, Region VI. No 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: F. GENERAL CHARACTERISTICS Suite No✓BIdg.No.: State: GIP Code: 2. Provide the estimated area of land disturbed (to the nearest acre): 7.14 Acres TCEQ-20022 (07/12/2004) Page 2 of 3 CER I'R''CATION James R. Nuse, P.E. Typed or printed name City Manager Title (Required) 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 canprovide documentation in proof of su auth ;- ation upon request. Signature: TCEQ-20022 (07/12/2004) e Blue Ink) Date: 0--11-1 — 0(a Page 3 of 3