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CM-11-08-168ROUND .RUCK, TEXAS PURPOSE. PASSION PARITY (a; (1) City Manager Approval Form Item Caption: Consider executing "Agent Authorization Form for Required Signature Edwards Aquifer Protection Progra Approval Date: 19 August 2011 Department Name: Parks and Recreation Department Project Manager: Rick Atkins Assigned Attorney: J. Kay Gayle Item Summary: The Chisholm Valley Park Improvement Project is located on the west side of IH 35 and is located over the Edward's Aquifer Recharge Zone. In order to proceed with construction of the proposed park improvements (playscape, pavilion, trail, practice field, and park amenities) the City is filing an Exception Request with the Texas Commission on Environmental Quality. Signature by the City Manager is Required for the Exception Request Application to be complete. No. of Originals Submitted: 1 Project Name: Cost: Source of Funds: Chisholm Valley Park Improvement Project $0 General Self -Financed Construction Source of Funds (if applicable): Select Source Fund Account Number: 6130-550-23000pk11rrpl_chvl Finance Director Approval: LO for C. Delaney Department Director Approval: Date: 8-16-11 Date: f-1 "Electronic signature by the Director is acceptable. please only submit ONE approval form per ite CIP ❑ a Budget N/A OK 111 N/A OK Purchasing 111 El N/A OK Accounting El El N/A OK ITEMS WILL NOT BE PLACED ON THE COUNCIL OR CM AGENDA W/OUT PRIOR FINANCE AND/OR LEGAL APPROVAL REV. 6/20/11 7 "ROUND ROCK, TEXAS PURPOSE. PASSION. PROSPERITY. RECHARGE ZONE EXCEPTION REQUEST FOR CHISHOLM VALLEY PARK IMPROVEMENT PROJECT ROUND ROCK, TEXAS Prepared by: City of Round Rock 301 West Bagdad St., Suite 250 Round Rock, Texas 78664 AUGUST 2011 0,1A--U-c6-110c6 General Information Form For Regulated Activities on the Edwards Aquifer Recharge and Transition Zones and Relating to 30 TAC §213.4(b) & §213.5(b)(2)(A), (B) Effective June 1, 1999 REGULATED ENTITY NAME: Chisholm Valley Park Improvement Proiect COUNTY: Williamson STREAM BASIN: Lake Creek EDWARDS AQUIFER: X, RECHARGE ZONE TRANSITION ZONE PLAN TYPE: _ WPAP _ SCS CUSTOMER INFORMATION 1. Customer (Applicant): Contact Person: David Buzzell _ AST _ UST X EXCEPTION MODIFICATION Entity: City of Round Rock Mailing Address: 221 East Main Street City, State: Round Rock, Texas Zip: 78664 Telephone: (512) 341-3345 FAX: (512) 218-5548 Agent/Representative (If any): Contact Person: Entity: Mailing Address: City, State: Zip: Telephone: FAX: 2. X This project is inside the city limits of Round Rock This project is outside the city limits but inside the ETJ (extra -territorial jurisdiction) of This project is not located within any city's limits or ETJ. 3. The location of the project site is described below. The description provides sufficient detail and clarity so that the TCEQ's Regional staff can easily locate the project and site boundaries for a field investigation. The proiect is located at 1201 Tray Street in Round Rock, Texas. The project site is on the west side of IH -35, south of McNeil Rd. and south of the existing rail road tracks. The site is adiacent to a white water tower and is surrounded on the east and south by single family residences in the Chisholm Valley neighborhood. 4. X ATTACHMENT A - ROAD MAP. A road map showing directions to and the location of the project site is attached at the end of this form. 5. X ATTACHMENT B - USGS / EDWARDS RECHARGE ZONE MAP. A copy of the official 7 �/2 minute USGS Quadrangle Map (Scale: 1" = 2000') of the Edwards Recharge Zone is attached behind this sheet. The map(s) should clearly show: TCEQ-0587 (Rev. 10-01-10) Page 1 of 3 X Project site. X USGS Quadrangle Name(s). X Boundaries of the Recharge Zone (and Transition Zone, if applicable). X Drainage path from the project to the boundary of the Recharge Zone. 6. X Sufficient survey staking is provided on the project to allow TCEQ regional staff to locate the boundaries and alignment of the regulated activities and the geologic or manmade features noted in the Geologic Assessment. The TCEQ must be able to inspect the project site or the application will be returned. 7. X ATTACHMENT C - PROJECT DESCRIPTION. Attached at the end of this form is a detailed narrative description of the proposed project. 8. Existing project site conditions are noted below: Existing commercial site Existing industrial site Existing residential site Existing paved and/or unpaved roads Undeveloped (Cleared) Undeveloped (Undisturbed/Uncleared) X Other: Existing Developed Park PROHIBITED ACTIVITIES 9. X I am aware that the following activities are prohibited on the Recharge Zone and are not proposed for this project: (1) waste disposal wells regulated under 30 TAC Chapter 331 of this title (relating to Underground Injection Control); (2) new feedlot/concentrated animal feeding operations, as defined in 30 TAC §213.3; (3) land disposal of Class I wastes, as defined in 30 TAC §335.1; (4) the use of sewage holding tanks as parts of organized collection systems; and (5) new municipal solid waste landfill facilities required to meet and comply with Type I standards which are defined in §330.41(b), (c), and (d) of this title (relating to Types of Municipal Solid Waste Facilities). 10. X I am aware that the following activities are prohibited on the Transition Zone and are not proposed for this project: (1) waste disposal wells regulated under 30 TAC Chapter 331 (relating to Underground Injection Control); (2) land disposal of Class I wastes, as defined in 30 TAC §335.1; and (3) new municipal solid waste landfill facilities required to meet and comply with Type I standards which are defined in §330.41 (b), (c), and (d) of this title. ADMINISTRATIVE INFORMATION 11. The fee for the plan(s) is based on: For a Water Pollution Abatement Plan and Modifications, the total acreage of the site where regulated activities will occur. TCEQ-0587 (Rev. 10-01-10) Page 2 of 3 NaMNIMI For an Organized Sewage Collection System Plans and Modifications, the total linear footage of all collection system lines. For a UST Facility Plan or an AST Facility Plan, the total number of tanks or piping systems. A request for an exception to any substantive portion of the regulations related to the protection of water quality. A request for an extension to a previously approved plan. 12. Application fees are due and payable at the time the application is filed. If the correct fee is not submitted, the TCEQ is not required to consider the application until the correct fee is submitted. Both the fee and the Edwards Aquifer Fee Form have been sent to the Commission's: TCEQ cashier Austin Regional Office (for projects in Hays, Travis, and Williamson Counties) San Antonio Regional Office (for projects in Bexar, Comal, Kinney, Medina, and Uvalde Counties) 13. X Submit one (1) original and one (1) copy of the application, plus additional copies as needed for each affected incorporated city, groundwater conservation district, and county in which the project will be located. The TCEQ will distribute the additional copies to these jurisdictions. The copies must be submitted to the appropriate regional office. 14. X No person shall commence any regulated activity until the Edwards Aquifer Protection Plan(s) for the activity has been filed with and approved by the Executive Director. To the best of my knowledge, the responses to this form accurately reflect all information requested concerning the proposed regulated activities and methods to protect the Edwards Aquifer. This GENERAL INFORMATION FORM is hereby submitted for TCEQ review. The application was prepared by: David Buzzell Print Name of Customer/Agent Signature of Customer/Agent Date If you have questions on how to fill out this form or about the Edwards Aquifer protection program, please contact us at 210/490- 3096 for projects located in the San Antonio Region or 512/339-2929 for projects located in the Austin Region. Individuals are entitled to request and review their personal information that the agency gathers on its forms. They may also have any errors in their information corrected. To review such information, contact us at 512/239-3282. TCEQ-0587 (Rev. 10-01-10) Page 3 of 3 ATTACHMENT A - Road Map Map UtpUt Pa 1 :1 http. ,g s3, ceg t temt . us s ietico a -r esri amEs m p Se iee re i% Jird 2SLC1 R [ t 1 ATTACHMENT C - PROJECT DESCRIPTION The Chisholm Valley Park Improvement Project can generally be described as the redevelopment of approximately 2.99 acres of existing parkland with a playscape, pavilion and approximately 1/6 mile of crushed granite trail with 6" concrete ribbon curb on either side and concrete sidewalk. All existing improvements including a wood playscape w/ wood borders, wood pavilion, concrete picnic table pads, and sand playground surfacing are approximately 30 years old and will be demolished and hauled off. Additional improvements included in the project will include a natural grass multipurpose practice field, picnic tables, benches, drinking fountain, trash receptacles, and park sign. In more detail, the project will involve removing approximately 1,307 sf of impervious cover consisting of existing concrete slabs and railroad tie borders, and installing approximately 6,732 sf of new impervious cover consisting of concrete sidewalks, slabs, and curbs. The current pervious area on-site is approximately 129,054 sf which will be only slightly reduced to 123,629 sf, or a change of 5,425 sf. The planned maximum depth of disturbance for the construction is to be less than two (2') feet. In general, grading of the site will be very similar to what exists today, and therefore drainage will remain as it exists today. Currently, approximately 98% of the site sheet flows northeast across a vegetated area with the other 2% of the site draining west to a grass lined roadway swale. Both drainage areas leave the site and flow across a large piece of vegetated, undeveloped property. The design proposes to keep the same drainage pattern with the only difference being the drainage flowing northeast will cross two sections of crushed granite trail, in addition to the turf area and proposed multipurpose sports field. Two small drainage swales are also being proposed in the design to direct water around a portion of the trail and prevent the playground drainage from entering an adjacent property. Due to the facts that the project will create a small net increase in impervious cover, that the depth of the construction excavation will be minimal, and that the majority of the storm water that falls on the completed project will sheet flow across vegetated surfaces, an exception from the requirements of filing a Water Pollution Abatement Pian (WPAP), performing a Geologic Assessment, and providing permanent water quality controls for the project is being requested. TCEQ-0587 Page 6 of 7 Recharge And Transition Zone Exception Request Form 30 TAC §213.9 Effective June 1, 1999 Regulated Entity Name: Chisholm Valley Park Improvement Proiect 1. X ATTACHMENT A - Nature of Exception. A narrative description of the nature of each exception requested is provided as ATTACHMENT A at the end of this form. All provisions of 30 TAC §213 Subchapter A for which an exception is being requested have been identified in the description. 2. X ATTACHMENT B - Documentation of Equivalent Water Quality Protection. Documentation demonstrating equivalent water quality protection for the Edwards Aquifer is provided as ATTACHMENT B at the end of this form. ADMINISTRATIVE INFORMATION 3. X Submit one (1) original and one (1) copy of the application, plus additional copies as needed for each affected incorporated city, groundwater conservation district, and county in which the project will be located. The TCEQ will distribute the additional copies to these jurisdictions. The copies must be submitted to the appropriate regional office. 4. X The applicant understands that no exception will be granted for a prohibited activity in Chapter 213. 5. X The applicant understands that prior approval under this section must be obtained from the executive director for the exception to be authorized. To the best of my knowledge, the responses to this form accurately reflect all information requested concerning the proposed regulated activities and methods to protect the Edwards Aquifer. This RECHARGE AND TRANSITION ZONE EXCEPTION REQUEST FORM application is hereby submitted for TCEQ review and executive director approval. The request was prepared by: David Buzzell Print Name of Customer/Agent Signature of Customer/Agent Date TCEQ-0628 (Rev. 10-01-10) ATTACHMENT A - NATURE OF EXCEPTION FOR RECHARGE AND TRANSITION ZONE EXCEPTION REQUEST FORM (TCEQ-0628) We request an exception from filing a Water Pollution Abatement Plan (WPAP) providing permanent water quality controls due to a small increase in new impervious cover and an exception to the Geologic Assessment due to the small area and depth of soil disturbance. The exception request will allow the City to redevelop approximately 2.99 acres of parkland with a new playscape, pavilion and approximately 1/6 mile of both 5' wide crushed granite w/6" concrete ribbon curb trail and concrete sidewalk with other park amenities, including benches and picnic tables. The total amount of planned impervious cover will be approximately 6,732 square feet, which is a change of 5,425 sf from the existing impervious cover. The approximate flow length across vegetated area from the new impervious cover to the discharge point/creek is approximately 900-1,000 feet. The project is small enough that the construction time will be short (3 months). It is our opinion that the large vegetated area will have sufficient Toad removal to handle the minimal new impervious cover created by this project. TCEQ-0628 Page 2 of 3 ATTACHMENT B - DOCUMENTATION OF EQUIVALENT WATER QUALITY PROTECTION Equivalent water quality protection for this construction will be achieved with the existence of the vegetated area to where the new impervious cover will be graded to. The construction will produce a small net increase in impervious cover (5,425 sf). There will also be some water quality benefit from the storm water permeating not only the vegetated areas of the park, but also the crushed granite trail, prior to leaving the project site and eventually discharging to Lake Creek. The vegetated area on the project site and downstream of the project site provide a vegetative buffer/filtration strip of approximately 900-1,000 feet which will have sufficient Toad removal to handle the minimal, new impervious cover created by this project. TCEQ-0628 Page 3 of 3 Temporary Stormwater Section for Regulated Activities on the Edwards Aquifer Recharge Zone and Relating to 30 TAC §213.5(b)(4)(A), (B), (D)(I) and (G); Effective June 1, 1999 REGULATED ENTITY NAME: Chisholm Valley Park Improvement Project POTENTIAL SOURCES OF CONTAMINATION Examples: Fuel storage and use, chemical storage and use, use of asphaltic products, construction vehicles tracking onto public roads, and existing solid waste. 1. Fuels for construction equipment and hazardous substances which will be used during construction: Aboveground storage tanks with a cumulative storage capacity of Tess that 250 gallons will be stored on the site for less than one (1) year. Aboveground storage tanks with a cumulative storage capacity between 250 gallons and 499 gallons will be stored on the site for less than one (1) year. Aboveground storage tanks with a cumulative storage capacity of 500 gallons or more will be stored on the site. An Aboveground Storage Tank Facility Plan application must be submitted to the appropriate regional office of the TCEQ prior to moving the tanks onto the project. X Fuels and hazardous substances will not be stored on-site. 2. X ATTACHMENT A - Spill Response Actions. A description of the measures to be taken to contain any spill of hydrocarbons or hazardous substances is provided at the end of this form. 3. N/A Temporary aboveground storage tank systems of 250 gallons or more cumulative storage capacity must be located a minimum horizontal distance of 150 feet from any domestic, industrial, irrigation, or public water supply well, or other sensitive feature. 4. X ATTACHMENT B - Potential Sources of Contamination. Describe in an attachment at the end of this form any other activities or processes which may be a potential source of contamination. There are no other potential sources of contamination. SEQUENCE OF CONSTRUCTION 5. X ATTACHMENT C - Sequence of Major Activities. A description of the sequence of major activities which will disturb soils for major portions of the site (grubbing, excavation, grading, utilities, and infrastructure installation) is provided at the end of this form. For each activity described, an estimate of the total area of the site to be disturbed by each activity is given. 6. X Name the receiving water(s) at or near the site which will be disturbed or which will receive discharges from disturbed areas of the project: Lake Creek TEMPORARY BEST MANAGEMENT PRACTICES (TBMPs) Erosion control examples: tree protection, interceptor swales, level spreaders, outlet stabilization, blankets or matting, mulch, and sod. Sediment control examples: stabilized construction exit, silt fence, filter dikes, rock berms, buffer strips, sediment traps, and sediment basins. Please refer to the Technical Guidance Manual for guidelines and specifications. All structural BMPs must be shown TCEQ-0602 (Rev. 10/01/04) Page 1 of 4 on the site plan. 7. X ATTACHMENT D - Temporary Best Management Practices and Measures. A description of the TBMPs and measures that will be used during and after construction are provided at the end of this form. For each activity listed in the sequence of construction, include appropriate control measures and the general timing (or sequence) during the construction process that the measures will be implemented. TBMPs and measures will prevent pollution of surface water, groundwater, and stormwater. The construction -phase BMPs for erosion and sediment controls have been designed to retain sediment on site to the extent practicable. The following information has been provided in the attachment at the end of this form a. A description of how BMPs and measures will prevent pollution of surface water, groundwater or stormwater that originates upgradient from the site and flows across the site. b. A description of how BMPs and measures will prevent pollution of surface water or groundwater that originates on-site or flows off site, including pollution caused by contaminated stormwater runoff from the site. c. A description of how BMPs and measures will prevent pollutants from entering surface streams, sensitive features, or the aquifer. d. A description of how, to the maximum extent practicable, BMPs and measures will maintain flow to naturally -occurring sensitive features identified in either the geologic assessment, TCEQ inspections, or during excavation, blasting, or construction. 8. The temporary sealing of a naturally -occurring sensitive feature which accepts recharge to the Edwards Aquifer as a temporary pollution abatement measure during active construction should be avoided. ATTACHMENT E - Request to Temporarily Seal a Feature. A request to temporarily seal a feature is provided at the end of this form. The request includes justification as to why no reasonable and practicable alternative exists for each feature. X There will be no temporary sealing of naturally -occurring sensitive features on the site. 9. N/A ATTACHMENT F - Structural Practices. Describe the structural practices that will be used to divert flows away from exposed soils, to store flows, or to otherwise limit runoff discharge of pollutants from exposed areas of the site. Placement of structural practices in floodplains has been avoided. 10. N/A ATTACHMENT G - Drainage Area Map. A drainage area map is provided at the end of this form to support the following requirements. For areas that will have more than 10 acres within a common drainage area disturbed at one time, a sediment basin will be provided. For areas that will have more than 10 acres within a common drainage area disturbed at one time, a smaller sediment basin and/or sediment trap(s) will be used. For areas that will have more than 10 acres within a common drainage area disturbed at one time, a sediment basin or other equivalent controls are not attainable, but other TBMPs and measures will be used in combination to protect down slope and side slope boundaries of the construction area. TCEQ-0602 (Rev. 10/01/04) Page 2 of 4 X There are no areas greater than 10 acres within a common drainage area that will be disturbed at one time. A smaller sediment basin and/or sediment trap(s) will be used in combination with other erosion and sediment controls within each disturbed drainage area. 11. N/A ATTACHMENT H - Temporary Sediment Pond(s) Plans and Calculations. Temporary sediment pond or basin construction plans and design calculations for a proposed temporary BMP or measure has been prepared by or under the direct supervision of a Texas Licensed Professional Engineer. All construction plans and design information must be signed, sealed, and dated by the Texas Licensed Professional Engineer. Construction plans for the proposed temporary BMPs and measures are provided as at the end of this form. 12. X ATTACHMENT I - Inspection and Maintenance for BMPs. A plan for the inspection of temporary BMPs and measures and for their timely maintenance, repairs, and, if necessary, retrofit is provided at the end of this form. A description of documentation procedures and recordkeeping practices is included in the plan. 13. X All control measures must be properly selected, installed, and maintained in accordance with the manufacturer's specifications and good engineering practices. If periodic inspections by the applicant or the executive director, or other information indicate a control has been used inappropriately, or incorrectly, the applicant must replace or modify the control for site situations. 14. X If sediment escapes the construction site, off-site accumulations of sediment must be removed at a frequency sufficient to minimize offsite impacts to water quality (e.g., fugitive sediment in street being washed into surface streams or sensitive features by the next rain). 15. N/A Sediment must be removed from sediment traps or sedimentation ponds not later than when design capacity has been reduced by 50%. A permanent stake will be provided that can indicate when the sediment occupies 50% of the basin volume. 16. X Litter, construction debris, and construction chemicals exposed to stormwater shall be prevented from becoming a pollutant source for stormwater discharges (e.g., screening outfalls, picked up daily). SOIL STABILIZATION PRACTICES Examples: establishment of temporary vegetation, establishment of permanent vegetation, mulching, geotextiles, sod stabilization, vegetative buffer strips, protection of trees, or preservation of mature vegetation. 17. X ATTACHMENT J - Schedule of Interim and Permanent Soil Stabilization Practices. A schedule of the interim and permanent soil stabilization practices for the site is attached at the end of this form. 18. X Records must be kept at the site of the dates when major grading activities occur, the dates when construction activities temporarily or permanently cease on a portion of the site, and the dates when stabilization measures are initiated. 19. X Stabilization practices must be initiated as soon as practicable where construction activities have temporarily or permanently ceased. ADMINISTRATIVE INFORMATION TCEQ-0602 (Rev. 10/01/04) Page 3 of 4 20. X All structural controls will be inspected and maintained according to the submitted and approved operation and maintenance plan for the project. 21. X If any geologic or manmade features, such as caves, faults, sinkholes, etc., are discovered, all regulated activities near the feature will be immediately suspended. The appropriate TCEQ Regional Office shall be immediately notified. Regulated activities must cease and not continue until the TCEQ has reviewed and approved the methods proposed to protect the aquifer from any adverse impacts. 22. X Silt fences, diversion berms, and other temporary erosion and sediment controls will be constructed and maintained as appropriate to prevent pollutants from entering sensitive features discovered during construction. To the best of my knowledge, the responses to this form accurately reflect all information requested concerning the proposed regulated activities and methods to protect the Edwards Aquifer. This TEMPORARY STORMWATER SECTION is hereby submitted for TCEQ review and executive director approval. The application was prepared by: David Buzzell, Print Name of Customer/Agent Signature of Customer/Agent Date TCEQ-0602 (Rev. 10/01/04) Page 4 of 4 ATTACHMENT A - SPILL RESPONSE ACTIONS Material storage areas should be maintained to keep material on-site material limited to material needed for the job at hand. Liquid containers will be kept closed when fluids are not being used and drip pans will be under any containers with valves or spigots attached. All spills of any size will be immediately contained and all contaminated material placed into a proper container designed for transporting the hazardous materials. Containers will be sent to an approved hazardous materials site for proper disposal. There is a City fire station approximately one (1) mile from the site with hazmat trained personnel on duty. The TCEQ will be contacted immediately as to the type and nature of all significant hazardous materials spills. The TCEQ will be notified as to the destination and travel days of any contaminated material. TCEQ-0602 Page 5 of 11 ATTACHMENT B - POTENTIAL SOURCES OF CONTAMINATION Possible sources of contamination are: 1. Vehicles (Traveling Public, Contractor's Trucks, & Employees) 2. Non -Road Legal Equipment (Skid Steers, Loaders, etc.) 3. Excavated Areas 4. Portland Cement Concrete 5. Construction Debris 6. Grease 7. Oil 8. Gas TCEQ-0602 Page 6 of 11 ATTACHMENT C - SEQUENCE OF MAJOR ACTIVITIES 1. Contractor will schedule phases of construction that do not exceed the work which can be completed within a week, not including the weekend. 2. Excavations will be closed for weekends, holidays, and any other days when work is not scheduled to proceed. 3. Install all of the project construction signage. 4. Install temporary erosion and sedimentation controls per plan. 5. Install the temporary construction entrance to the site. 6. Install the concrete truck wash out area, per plan. 7. Perform Items 8 through 20 as applicable. 8. Excavate areas to be worked. 9. Haul away all spoils as excavated. 10. Grade and compact sub -grade. 11. Deliver, install and compact flexible base material as needed. 12. Form, install steel, pour, and finish concrete as needed. 13. Deliver, install and compact backfill. 14. Deliver, install, compact decomposed crushed granite trail material. 15. Deliver, install playscape elements. 16. Deliver, install site furnishings (benches, picnic tables, trash receptacles). 17. Install tree irrigation system. 18. Deliver and install top soil, hydroseed, and vegetation. 19. Deliver and install signage. 20. Clean existing pavement adjacent to the work site at the close of each work day. 21. Collect all construction debris and place in a covered container, at least daily. 22. Repeat Task Items 8 through 20 until project acceptance letter is received by contractor. 23. Final walk-through with the Contractor and Owner. 24. Final acceptance letter for the project. 25. Remove all of the project construction signage. *Note: Contractor will use a portion of the existing turf area/sports field during construction to maneuver equipment and materials around the project site. All areas of turf that are disturbed during construction will be raked, aerated and re- seeded. TCEQ-0602 Page 7 of 11 ATTACHMENT D - TEMPORARY BEST MANAGEMENT PRACTICES AND MEASURES (TBMP'S) TBMP's proposed to be utilized in the temporary Storm Water Pollution Plan (SW3P) during the construction of the proposed Chisholm Valley Park Improvement Project: 1. Construction phases are to be completed in the same work week to minimize exposure. 2. Perimeter silt fence to be installed around site 3. Construction entrance/exit will be installed 4. Temporary concrete truck washout area will be installed and removed prior to completion. 5. Check and re -set run-off control measures at the end of each work day and before a predicted storm event. 6. Provide and maintain covered trash and debris containers. 7. Control employee and equipment parking. 8. Daily maintenance of the control measures. 9. Work restrictions on Ozone Action Days. 10. All disturbed areas in the vegetated area will be revegetated. TCEQ-0602 Page 8 of 11 ATTACHMENT I - INSPECTION AND MAINTENANCE FOR TBMP'S All temporary erosion and sedimentation control measures must be maintained to have an effective operating condition. Inspection of TBMP's will be required every 14 days or after a rainfall event greater than 0.5 inches. If site inspections identify TBMP's are not operating effectively, maintenance shall be performed as necessary to maintain the continued effectiveness of storm water controls. After construction is complete, the park facility will be regularly inspected and maintained on a two week rotation minimum. Maintenance of the park includes regular mowing practices, clearing of debris, and general up keep of the site. Park amenities such as pavilions, benches, and picnic tables are inspected for soundness twice every week. In the event a repair/retrofit needs to be made, depending on the situation, maintenance crews will restrict access to the site and make repairs. Every effort will be made to disturb as little area as possible. All disturbed areas will be re -vegetated and maintained. TCEQ-0602 Page 10 of 11 ATTACHMENT J - SCHEDULE OF INTERIM AND PERMANENT SOIL STABILIZATION PRACTICES Permanent soil stabilization practices will be used, including the use of sod and/or hydro -seed to establish permanent vegetation. Stabilization measures shall be on-going as each phase of construction activities progresses. All erosion and sedimentation controls will remain in place until permanent vegetation is established. TCEQ-0602 Page 11 of 11 Agent Authorization Form For Required Signature Edwards Aquifer Protection Program Relating to 30 TAC Chapter 213 Effective June 1, 1999 I Steve Norwood Print Name City Manager Title - Owner/President/Other of the City of Round Rock Corporation/Partnership/Entity Name have authorized David Buzzell, RLA, ASLA Print Name of Agent/Engineer of City of Round Rock — PARD 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) Page 1 of 2 SIGNATURE PAGE: Steve Norwood, City Manager Date THE STATE OF )USS § County of I w AM5 i4 § BEFORE ME, the undersigned authority, on this day personally appeared S EW€, l lornA known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that (,g he executed same for the purpose and consideration therein expressed. GIVEN under my hand and seal of office on this 23Cday of "��1"1'' MEAGAN M. SPINKS ����'�Y OVA =`°'' �'`�""_. Notary Public, State of Texas ,•. My Commission Expires 'v ,�;giFf September 09, 2014 NOTARY UBLI MEAGArki AA. ' 1:71t4 KS Typed or Printed Name of Notary MY COMMISSION EXPIRES: //q/2014 TCEQ-0599 (Rev.04/01/2010) Page 2 of 2 Texas Commission on Environmental Quality Edwards Aquifer Protection Program Application Fee Form NAME OF PROPOSED REGULATED ENTITY: Chisholm Valley Park Improvement Project REGULATED ENTITY LOCATION: Round Rock, Texas NAME OF CUSTOMER: City of Round Rock CONTACT PERSON: David Buzzell PHONE: (512) 341-3345 (Please Print) Customer Reference Number (if issued): CN Regulated Entity Reference Number(if issued): RN 600413181 (nine digits) N/A (nine digits) Austin Regional Office (3373) 0 Hays 0 Travis X Williamson San Antonio Regional Office (3362) ❑ Bexar 0 Comal ❑ Medina ❑ Kinney ❑ Uvalde Application fees must be paid by check, certified check, or money order, payable to the Texas Commission on Environmental Quality. Your canceled check will serve as your receipt. This form must be submitted with your fee payment. This payment is being submitted to (Check One): X Austin Regional Office 0 Mailed to TCEQ: TCEQ — Cashier Revenues Section Mail Code 214 P.O. Box 13088 Austin, TX 78711-3088 0 San Antonio Regional Office 0 Overnight Delivery to TCEQ: TCEQ - Cashier 12100 Park 35 Circle Building A, 3rd Floor Austin, TX 78753 512/239-0347 Site Location (Check All That Apply): X Recharge Zone 0 Contributing Zone 0 Transition Zone Water Pollution Abatement Plan, Contributing Zone Plan: One Single Family Residential Dwelling Size Acres Fee Du Water Pollution Abatement Plan, Contributing Zone Plan: Multiple Single Family Residential and Parks Acres Water Pollution Abatement Plan, Contributing Zone Plan: Non-residential Acres Sewage Collection System L.F. Lift Stations without sewer lines Acres Underground or Aboveground Storage Tank Facility Tanks $ Piping System(s)(only) Each Exception Each $500.00 Extension of Time Each If you have questions on how to fill out this form or about the Edwards Aquifer protection program, please contact us at 210/490- 3096 for projects located in the San Antonio Region or 512/339-2929 for projects located in the Austin Region. Individuals are entitled to request and review their personal information that the agency gathers on its forms. They may also have any errors in their information corrected. To review such information, contact us at 512/239-3282. TCEQ-0574 (Rev. 4/25/08) Page 1 of 2 Texas Commission on Environmental Quality Edwards Aquifer Protection Program Application Fee Schedule 30 TAC Chapter 213 (effective 05/01/2008) Water Pollution Abatement Plans and Modifications Contributing Zone Plans and Modifications One Single Family Residential Dwelling PROJECT AREA IN ACRES. <5 $650 Multiple Single Family Residential and Parks <5 5<10 10 < 40 40 < 100 100 < 500 >- 500 Non-residential (Commercial, industrial, institutional, multi -family residential, schools, and other sites where regulated activities will occur) <1 1<5 5<10 10<40 40 < 100 >_ 100 $1,500 $3,000 $4,000 $6,500 $8,000 $10,000 $3,000 $4,000 $5,000 $6,500 $8,000 $10,000 Organized Sewa PROJECT COST PER LINEAR FOOT MINIMUM FEE MAXIMUM FEE Sewage Collection Systems $0.50 $650 - $6,500 • • V. ■ .4 0 U. VM111M CU IM .-.vvVGVI %MI Nu �wi aarumst ya • arum syem racndifi ity I. -fans ana modcations PROJECT COST PER TANK OR PIPING SYSTEM MINIMUM FEE MAXIMUM FEE Underground and Aboveground Storage Tank Facility $650 $650 - $6,500 Exception Requests Exception Request $500 Extension of Time Requests Extension of Time Request $150 TCEQ-0574 (Rev. 4/25/08) Page 2 of 2 11 mikago 10ECI TCEQ Core Data Form For detailed instructions regarding completion of this form, please read the Core Data Form Instructions or call 512-239-5175. SECTION I: General Information 1. L Reason for Submission (If other is checked please describe in space provided) New Permit, Registration or Authorization (Core Data Form should be submitted with the program application) ❑ Renewal (Core Data Form should be submitted with the renewal form) ❑ Other Recharge Zone Exception Request 2. Attachments Describe Any Attachments: (ex. Title VApplication, Waste TransporterApplication, etc.) 7. General Customer Information Iril Yes No Exception Request 3. Customer Reference Number (if issued) Follow this link to search 4. Regulated Entity Reference Number (if issued) for CN or RN numbers in 600413181 CN RN N/A Central Registry** SECTION II: Customer Information 5. Effective Date for Customer Information Updates (mm/dd/yyyy) 08/15/2011 (See below) 6. Customer Role (Proposed or Actual) - as it relates to the Regulated Entity listed on this form. Please check only one of the following. ❑Owner ❑ Operator ❑Occupational Licensee ❑ Responsible Party x ❑ Owner & Operator Voluntary Cleanup Applicant ❑Other: 7. General Customer Information ❑ New Customer ❑ Update to Customer Information ❑Change in Legal Name (Verifiable with the Texas Secretary of State) ❑ E Change in Regulated Entity Ownership No Change** **/f "No Change" and Section lis complete, skip to Section Ill - Regulated Entity Information. 8. Type of Customer: ❑ Corporation ❑ Individual ❑ Sole Proprietorship- D.B.A ❑ City Government ❑ County Government ❑ Federal Government ❑ State Govemment ❑ Other Government ❑ General Partnership ❑ Limited Partnership ❑ Other: 9. Customer Legal Name Ifanindividual, last name first. new Customer, enter previous Customer ( Doe, print ex: John)if P End Date: below 10. Mailing Address: City State ZIP ZIP + 4 11. Country Mailing Information (if outside USA) 12. E -Mail Address (if applicable) 13. Telephone Number ( ) - 1 14. Extension or Code 15. Fax Number (if applicable) 1( ) - 16. Federal Tax ID (sdiglts) 17. TX State Franchise Tax ID (11 digits) 18. DUNS Nurnberg applicable) 19. TX SOS Filing Number (irappiicabte) 20. Number of Employees ❑ 0-20 ❑ 21-100 ❑ 101-250 ❑ 251-500 ❑ 501 and higher 21 Independently Owned and Operated? 1 ❑ Yes ❑ No SECTION III: Regulated Entity Information 22. General Regulated Entity Information (If New Regulated Entity"is selected below this form should be accompanied by a permit application) x New Regulated Entity ❑ Update to Regulated Entity Name ❑ Update to Regulated Entity Information ❑ No Change** (See below) **If "NO CHANGE" is checked and Section I is complete, skip to Section IV, Preparer Information. 23. Regulated Entity Name (name of the site where the regulated action is taking place) CHISHOLM VALLEY PARK IMPROVEMENT PROJECT TCEQ-10400 (09/07) Page 1 of 2 24. Street Address of the Regulated Entity: (No P.O. Boxes) 1201 Tray Street 36. Nearest City County State Nearest ZIP Code City Round Rock State TX ZIP 78664 ZIP + 4 Date: Degrees 25. Mailing Address: City of Round Rock -Parks & Recreation Department 301 W. Bagdad St., Ste. 250 Seconds City Round Rock State TX ZIP 78664 ZIP + 4 ■ 26. E -Mail Address: dbuzzell@round-rock.tx.us 27. Telephone Number 28. Extension or Code 29. Fax Number (ifapp/icable) ( 512 )341_ 3345 Sludge ( 512 ) 218_ 5548 30. Primary SIC Code (4 digits) 31. Secondary SIC Code (4 digits) 32. Primary NAICS Code 33. Secondary NAICS Code (5 or 6 digits) (5 or 6 digits) N/A N/A N/A N/A 34. What is the Primary Business of this entity? (Please do not repeat the SIC or NAICS description.) Outdoor Recreation - Park Questions 34 - 37 addressgeographic location. Please ref 35. Description to Physical Location: North on IH35 from Austin. Exit McNeil Rd, go west (left turn) on McNeil Rd. Turn left on St. Williams St. Immediate left on Bellview Ave. Turn right on Tray St. 36. Nearest City County State Nearest ZIP Code Round Rock Williamson Texas 78664 37. Latitude (N) In Decimal: ■ 38. Longitude (W) In Decimal Date: Degrees Minutes Seconds Degrees Minutes Seconds 30 29 48.7139 —97 41 15.6471 39. TCEQ Programs and ID Numbers Check all Programs and write in the permits/registration numbers that will be affected by the updates submitted on this form or the updates may not be made. If your Program is not listed, check other and write it in. See the Core Data Form instructions for additional nuidance. ■ Dam Safety • Districts Lit Edwards Aquifer • Industrial Hazardous Waste ■ Municipal Solid Waste Date: rreC'3/77. iiifr— ,40.-- • New Source Review - Air • OSSF ■ Petroleum Storage Tank • PWS • Sludge • Stormwater IN Title V - Air • Tires • Used Oil • Utilities • Voluntary Cleanup • Waste Water ■ Wastewater Agriculture ■ Water Rights • Other: SECTION IV: Preparer Information 40. Name: David Buzzell, R.L.A. 41. Title: Park Development Manager 42. Telephone Number 43. Ext./Code 44. Fax Number 45. E -Mail Address ( 512) 341 _ 3345 512)218. 5548 dbuzzell@round-rock.tx.us SECTION V: Authorized Signature 46. By my signature below, I certify, to the best of my knowledge, that the information provided in this form is true and complete, and that I have signature authority to submit this form on behalf of the entity specified in Section II, Field 9 and/or as required for the updates to the ID numbers identified in field 39. (See the Core Data Form instructions for more information on who should sign thisform. Company: Etiv of I"a ID oc.i Job Title: &tY NI MIG .. Name(rnprint): 5TEre" KERw'*D1 Phone: (51d) t -5+10 Signature: Date: rreC'3/77. iiifr— ,40.-- TCEQ-10400 (09/07) Page 2of2