CM-08-05-128SUBJECT: City Manager - May 14, 2008
ITEM: Action authorizing the City Manager to execute a Notice of Intent (NOI) with
the Texas Commission on Environmental Quality (TCEQ) General Storm Water
Permits Division for Old Settlers Boulevard (Kiphen Road Phase II) Project.
Department: Transportation Services
Staff Person: Thomas G. Martin, P.E., Director of Transportation Services
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 27 acres, a NOI is required.
Funding:
Cost: $325.00
Source of funds: 4B - Round Rock Transportation Development Systems Corporation
Outside Resources: RGM Constructors
Background Information:
RGM constructors is widening Old Settler Boulevard (Kiphen Road). From the Missouri,
Kansas, Texas (MKT) Right of Way to Red Bud Lane. The TCEQ has recently updated its
rules and regulations for a NOI. As of March 3, 2008, all current NOIs must be renewed
before June 3, 2008, or they will expire. Since this NOI was submitted to TCEQ prior to
March 3, 2008, the CORR is required to submit a NOI renewal.
Public Comment: N/A
Blue Sheet Format
Updated 01/20/04
TCEQ Office Use Only
rotNotice of Intent (NOI) for Storm Water Permit No.: TXR15
- - Discharges Associated with Construction RN:
MIN
Activity under TPDES General Permit CN:
TCEQ (TXR150000) Ref No:
Sign up now for ePermits vOI
flet instant Permit (Ark eratgt
e•s.Y..a° If filing a paper NOI you can pay the
v Y
a.
►5 Select Fee Tvne: GENERAL PERMIT
at ltttt►s:i/www6.teeq.state.tx.us/steers/
mid ,:,stly pad' a S225 application fee.
application fee on line? Go to https:......6.tceq.state.tx.us,'epay,'
CONSTRUCTION STORM WATER DTSCHARGE NOI APPLICATION
IMPORTANT:
•Use the INSTRUCTIONS to fill out each question in this form.
•Use the attached CUSTOMER CHECKLIST to make certain all you filled out all required information.
•Incomplete applications WILL delay approval or result in automatic Denial.
Renewal of
Is this NOI
General Permit
to renew an ACTIVE permit?
es - What is your permit number? Permit No. TXR15
- a permit number will be issued.
BM74
✓
❑No
Application Fee if mailing a paper NOI:
You must pay the 5325 Application Fee to TCEQ for the application to be considered complete.
Payment and NOI must be mailed to separate addresses. See instructions for correct mailing addresses.
Provide your payment information below, for us to verify payment of the application fee:
✓ Mailed:
Check/Money Order No.:
Company Name on checking account:
EPAY:
Voucher No.:
Is the Payment Voucher copy attached? ❑Yes
A. OPERATOR (applicant)
1. If the applicant is currently a customer with TCEQ, what is the Customer Number (CN) issued to this entity?
CN 11047 (Search Central Rettistr. )
2. What is the Legal Name of the entity (applicant) applying for this permit?
City of Round Rock
(The legal name must be spelled exactly as filed with the Texas Secretary of State, County, or in the legal document forming the entity.)
3. What is the name and title of the person signing the application?
(The person must be an official meeting signatory requirements in TAC 305.43(a).)
Name: James R. Nuse
Job Title: City Manager
4. What is the Operator's (applicant) mailing address as recognized
by the US Postal Service? (. erih at USPS.con)
Address: 221 East Main Street Suite No./Bldg. No./Mail Code: NIA
City: Round Rock state: Texas ZIP Code: 78664
Country Mailing Information (if outside USA). Country Code: Postal Code:
5. Phone No.: ( 512 ) 218-3237
Extension: N/A
6. Fax No.: ( 512) 218-3242
E-mail Address: bstablein@round-rock.tx.us
7. Indicate the type of Customer:
❑ Individual ❑Sole Proprietorship-D.B.A.
■ Corporation []Federal Government
❑ State Government OCounty Government
Other Government DOther (describe):
❑Limited Partnership
[General Partnership
/ City Government
20022 (03/05/2008)
Cm -06-05- la '
Page I
8. Independent Operator:
■
Yes
GI
No (If govemmental entity, subsidiary, or part of a larger corporation, check "No".)
9. Number of Employees:
■ 0-20;
■
21-100;
■ 101-250;
■
251-500; or
p
501 or higher
10. Customer Business Tax and Filing Numbers ("Phis item is not applicable to Individuals, Government, GP or Sole Proprietor.)
REQUIRED for Corporations and Limited Partnerships ( V'+'nt the entity ,s status and filing no. 6. ith FX SOS at 512,463-5555 )
State Franchise Tax ID Number:
Federal Tax ID:
TX SOS Charter (filing) Number:
DUNS Number (if known):
B. APPLICATION CONTACT
If TCEQ needs additional information regarding this application, who should be contacted?
1. Name: Bill Stablein
Title: Project Manager
Company: City of Round Rock
2. Phone No.: ( 512 ) 218-3237
Extension: N/A
3. Fax No.: 512 218-3242
E-mail Address: bStablein Q@round-rock.tx.us
C. REGULATED ENTITY (RE) INFORMATION ON PROJECT OR SITE
1. TCEQ Issued RE Reference Number (RN): RN N/A
(S&.a, t h Central Reaistrv)
2. Name of Project or Site (the name as known by the community where this facility/project is located):
Kiphen Road - Phase II
(example: phase and name of subdivision or name of project that's unique to the site)
3. Does the site have a physical address?
If Yes, complete Section A for a physical address.
If No, complete Section B for site location information.
Section A: Enter the physical address for the site. (1erilt it Bi ill] USPS.com or other deliver. source)
Street Number:
Street Name:
City:
ZIP Code:
Section B: Enter the site location information.
If no physical address (Street Number & Street Name), provide a written location access description to the site:
(Ex.: phase 1 of Woodland subdivision located 2 miles west from intersection of Hwy 290 & 1H35 accessible on Hwy 290 South)
Kiphen Rd. from FM 1460 to CR 113 & CR122
City where the site is located or nearest city to site:
Round Rock
ZIP Code where site is located:
78664
4. Identify the county where the site is located:
5. Latitude: 30 Degrees 32' 40" N
Longitude: .097 Degrees 38' 28" W
6. What is the primary business of this entity? In your own words, briefly describe the primary business of the Regulated Entity:
(Do not repeat the SIC and NAICS code)
City Govemment
7. What is the mailing address for the regulated entity?
Is the RE mailing address the same as the Operator? UYes, address is the same as Operator
i
No, provide the address
Street Number: 2008
Street Name: Enterprise Drive
City: Round Rock
state: Texas
ZIP Code: 78664
D. GENERAL CHARACTERISTICS
1. Is the site located on Indian Country Lands? + No ❑Yes — If Yes, do not submit this NOI. Contact EPA, Region VI
If the site is on Indian country lands, you must obtain authorization through EPA, Region VI.
2. What is the Standard Industrial Classification (SIC) code (see instructions for common codes): (Search Osha.w,. )
Primary: Yes Secondary: NO
TCEQ-20022 (03/05/2008)
Page 2
3(a) What is the
total number of acres disturbed? 27
3(b) Is the project
If Yes, the total
If No, the total
project site does
general permit
site part of a larger common plan of development or sale? ❑Yes 1 No
number of acres disturbed can be less than 5 acres.
number of acres disturbed must be 5 or more. If the total number of acres disturbed is less than 5 then the
not qualify for coverage through this Notice of Intent. Coverage will be denied. See the requirements in the
for small construction sites.
4. Discharge Information (all information MUST be provided or the permit will be denied)
4(a) What is the name of the water body(s) to receive the storm water runoff or potential runoff from the site?
McNutt Creek
4(b) What is the segment number(s) of the classified water body(s) that the discharge or potential discharge will eventually
reach? Not Available
4(c) Are any
303(d) list of
❑ Yes
If Yes, provide
of the surface water bodies receiving discharges from the construction site on the latest EPA -approved CWA
impaired waters?
1 No
the name of the im aired water bod s .
4(d) Is the discharge
If Yes, what
Note: The
into an MS4? DYes o No
is the name of the MS4 Operator?
general permit requires you to send a copy of the NOI to the MS4 Operator.
4(e) Is the discharge
Transition Zone
or potential discharge within the Recharge Zone, Contributing Zone, or Contributing Zone within the
of the Edwards Aquifer?
❑ No
Yes, please note that a copy of the agency approved Plan required by the Edwards Aquifer Rule (30 TAC Chapter 213) must
referenced in the Storm Water Pollution Prevention Plan.
1 Yes
If the answer is
be included or
E. CERTIFICATION
Check "Yes" to the certifications below. Failure 10 certify to all items will result in denial.
Yes
I certify that I have obtained a copy and understand the terms and conditions of the general permit (TXR150000).
i Yes
I certify that the full legal name of the entity (Operator) applying for this permit has been provided and is legally
authorized to do business in Texas.
i Yes
I understand that a Notice of Termination (NOT) must be submitted when this authorization is no longer needed.
Yes
I certify that a storm water pollution prevention plan has been developed and implemented prior to construction,
and that is compliant with any applicable local sediment and erosion control plans and prepared and implemented
as required in the general permit TXR150000.
Operator Certification:
I, James R. Nuse City Manaaer
certify under penalty
to assure that qualified
system, or those
accurate, and complete.
knowing violations.
I further certify
proof of such authorization
Signature:
Typed or printed name (Required .Y nwer he le rihlt) Title (A%guired .3/ legible)
of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the
persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
that I am authorized under 30 Texas Adrninistrative Code §305.44 to sign and submit this document, and can provide documentation in
upon request.
Date: 51. iu r OB
(Use blue ink)
TCEQ-2002? (di3/05/2008)
, ./6•oe
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