CM-12-06-110RECEIVED
JUN2024/
ROUND ROCK, TEXAS City Manager Approval Form
PURPOSE PASSION. PROSPERITY
Consider executing TCEQ forms "Agent Authorization Form for Required Signature Edwards Aquifer Protection
Program Relating to 30 TAC Chapter 213" authorizing Peter Lai and Kevin Chumbley to represent and act on behalf of
Item Caption: the City for the 2011 Wastewater Collection System Rehabilitation (1st year - 2nd cycle) Proiect.
Approval Date: June 22, 2012
Department Name: Utilities and Environmental Services Department
Project Manager: Eddie Zapata
Assigned Attorney:
Steve Sheets
Item Summary:
The City of Round Rock is required, by the Texas Commission on Environmental Quality, to inspect and rehabilitate the wastewater
collection system that is located over the Edwards Aquifer every five years. This project is for the rehabilitation of the wastewater
collection system in five sub -basins, most of which are located over the Edwards Aquifer Recharge Zone (EARZ) and as a result, the
City must address the EARZ requirements. These requirements include the City obtaining an Organized Sewer Collection System
(SCS) approval from TCEQ prior to conducting the work. By the City executing the Agent Authorization form, this will authorize the
City's consultants, Peter Lai and Kevin Chumbley of RJN Group, Inc., to act as an agent to the City and submit the application for
approval of the SCS for this project.
No. of Originals Submitted: 2
Project Name: 2011 Wastewater Collection System Rehabilitation
Cost: N/A
Source of Funds: Select Source Fund
Source of Funds (if applicable): Select Source Fund
Account Number: wwOSrhb2011
Finance Director Approval: Cheryl Delaney
Department Director Approval: Michael Thane
CIP I I I I Budget
N/A OK
El El
N/A OK
Date: 6/20/12
Date: 6/18/12
Purchasing
El El
N/A OK
Accounting
E L1
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
Agent Authorization Form
For Required Signature
Edwards Aquifer Protection Program
Relating to 30 TAC Chapter 213
Effective June 1, 1999
of
have authorized
of
Michael Thane, P.E.
Print Name
Director of Utilities
Title - Owner/President/Other
City of Round Rock Utilities Department
Corporation/Partnership/Entity Name
Kevin Chumblev and Peter Lai
Print Name of Agent/Engineer
RJN Group, 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 applicants 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.
TCEQ-0599 (Rev.10/01/04) Page 1 of 2
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.
Applicant's Signature Date
THE STATE OFIXaS §
County of W t 11115 4 §
BEFORE ME, the undersigned authority, on this day personally appearedSCR ��'v&4 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 2Z' day of C ,2o1.
bs SARA LEIGH WHITE
MY COMMISSION EXPIRES
July 11, 2016
TCEQ-0599 (Rev.10/01/04)
144/1A.-- (At5ttt
NOTARY PUBLIC
Typed or Printed Name of Notary"
MY COMMISSION EXPIRES: ` U I tilt I C
Page 2 of 2