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Missing Data - ADMIN - 9/14/2014 11:09:30 PMROUND ROCK, TEXAS PURPOSE A.SSIOK PROSPERITY C,'1 1Z-Dg4RtCEIVED V. 20i1L City Manager Approval Form Consider execution of Edwards Aquifer Recharge and Transition Exception Request with the TCEQ for the FM 3406 Improvement Project. Item Caption: Approval Date: August 24, 2012 Department Name: Transportation Department Project Manager: Bill Stablein Assigned Attorney: Steve Sheets Item Summary: The FM 3406 Roadway Improvement Project will widen the existing roadway from an undivided four -lane roadway to a four -lane divided roadway with curb and gutter sections. This project is located in the Edwards Aquifer Recharge Zone and is under the control of the Texas Commission for Environmental Quality's (TCEQ) Edwards Aquifer rules related to storm water runoff. Approval of the Edwards Aquifer Recharge and Transition Exception Request by TCEQ is required before construction of the FM 3406 Roadway Improvement Project can commence. The City Manager's signature is needed on this Edwards Aquifer Recharge and Transition Exception Request under 30 TAC 213 Sub -Chapter A, Rule 213.9. No. of Originals Submitted: Two Project Name: FM 3406 Roadway Improvement Project Cost: None Source of Funds: Select Source Fund Source of Funds (if applicable): Select Source Fund Account Number: Finance Director Approval: Cheryl Delaney Date: 8/22/12 Department Director Approval: Gary Hudder Date: 8/20/12 -eco on:c sigricture by th2 CIP❑ Budget n n Purchasing n n Accounting ❑ N/A OK N/A OK N/A OK 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 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: Old Settlers Blvd Intersection Improvements 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 less 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: Chandler & Onion Branch of Brushy Creek TCEQ-0602 (Rev. 10/01/04) Page 1 of 4 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 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. X 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. X 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. X 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 TCEQ-0602 (Rev. 10/01/04) Page 2 of 4 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. 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. X 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. TCEQ-0602 (Rev. 10/01/04) Page 3 of 4 19. X Stabilization practices must be initiated as soon as practicable where construction activities have temporarily or permanently ceased. ADMINISTRATIVE INFORMATION 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 1 director approval. The application was prepared by: Kelly Morrelli, P.E. (Agent) Print Name of Customer/Agent Signature oustomer/Agent g 1,/2 Dat TCEQ-0602 (Rev. 10/01/04) Page 4 of 4 Partners for a Better Quality of Life Form TCEQ-0602 Attachments ATTACHMENT A — SPILL RESPONSE ACTIONS Should an accidental release occur, it will be immediately contained by earthen dikes, berms or other appropriate measures. Free liquids will be stabilized promptly using bulking agents, absorbent pads, booms, soil or other appropriate material. Once no free liquids are present in the containment area, the released material will be picked up mechanically or by personnel wearing proper protective equipment and stored in 55 gallon steel drums or on plastic sheeting. Released material will be covered to prevent contact with stormwater. Stormwater runoff will be diverted around the stored material if necessary. Traffic will be routed around and away from any spill are to avoid spreading the spilled material to other areas. Only qualified licensed personnel will be involved with the actual handling and removal of the spilled material. The Contractor is required to remediate any spills, and to immediately report spills (including sanitary sewer discharge) of reportable quantities to the National Response Center at (800) 424-8802, and one of the following: State Emergency Response Center (800) 832-8224 (if after hours), or to the TCEQ Regional Office (512) 339-2929 (if during business hours). Spills shall be reported within 24 hours unless other regulations require more expedient notification. ATTACHMENT B — POTENTIAL SOURCES OF CONTAMINATION Potential sources of contamination include the hydrocarbons and fuels required to service and operate the construction equipment, the materials and liquids used to conduct paving operations, various paints and solvents, and soil disturbed and mobilized during excavation. ATTACHMENT C — SEQUENCE OF MAJOR EVENTS The General Contractor will ultimately be responsible for the sequence of construction for this project, however, it is anticipated that the general sequence of activities will be as follows: 1. Install temporary stormwater BMPs (Sediment Control Fence, Erosion Control Logs, Rock Filter Dam) per erosion and sedimentation control plan. 2. Grade site, excavating cut sections and embanking fill sections. 3. Construct roadway (i.e. construct detours, drainage construction, paving) making minor adjustments to silt fencing and rock filter dams as needed; apply temporary seeding as needed. 4. Striping/pavement marking applications. The Avallon, Building I 10415 Morado Circle, Suite 200 Austin, Texas 78759 512.349.0700 • 512.349.0727 fax www.cpyi.com cp&y Partners for a Better Quality of Life 5. Site cleanup. 6. Place permanent seeding in areas where grading is completed. 7. Removal of remaining temporary erosion control devices. Appropriately sized erosion control measures will be utilized until vegetation is reestablished. ATTACHMENT D — TEMPORARY BEST MANAGEMENT PRACTICES During the construction phase, rock berms, sediment control fence, erosion control logs, and inlet protection will be installed at the beginning of the construction phase at surface water discharge points to reduce the potential for erosion. All temporary BMPs will remain until the end of construction. Offsite water flows into the project and through these temporary BMPs, preventing pollution of surface water, groundwater or stormwater. On-site water flows into and through the same temporary BMPs, preventing pollution of surface water, groundwater or stormwater. By slowing down the offsite and on-site water, pollutants will have time to settle to the bottom of the temporary BMPs allow proper removal before entering surface streams, sensitive features or the aquifer. Existing drainage paths will not be affected by the temporary BMPs. The locations of temporary BMPs are shown on the Temporary Erosion and Sedimentation Control Plan sheets. Standard details show information relevant to BMP installation and maintenance. ATTACHMENT E — REQUEST TO TEMPORARILY SEAL A FEATURE Not applicable. ATTACHMENT F — STRUCTURAL PRACTICES Sediment derived from excavation and grading will be controlled through the use of rock berms, sediment control fence, erosion control logs, construction exits and inlet protection. The Availon, Building I 10415 Morado Circle, Suite 200 Austin, Texas 78759 512.349.0700 • 512.349.0727 fax www.cpyi.com CRS Partners for a Better Quality of life ATTACHMENT G — DRAINAGE AREA MAP Attached — Drainage Area Map & Site Plan sheet. ATTACHMENT H — TEMPORARY SEDIMENT POND PLAN AND CALCULATIONS Sediment ponds are not planned for this project. ATTACHMENT I — INSPECTION AND MAINTENANCE FOR BMPS Key to maintaining the performance of and efficiency of the temporary BMPs is inspection and repair when needed. The project will use an established schedule of inspection to identify the weak or failing sections of the sediment controls and institute repairs immediately to ensure the continued performance of the installed BMPs. BMPs will be inspected at least once every fourteen (14) calendar days and within twenty four (24) hours of the end of a storm of 0.5 inches or greater. An inspection and maintenance report shall be prepared and maintained onsite by qualified personnel. Damaged BMPs will either be repaired or replaced as needed. If storms damage the BMPs, efforts will be made immediately to restore them to original performance levels. Should damage exceed the capacity to repair during storm events, alternate methods such as temporary fiber rolls or rock dams will be available. Other inspection and maintenance data can be found in the "SW3P Construction Notes" sheet. ATTACHMENT J — SCHEDULE OF INTERIM AND PERMANENT SOIL STABILIZATION PRACTICES When soil disturbance activities cease at a location, immediate soil stabilization actions will be implemented. Disturbed areas on which construction activities have ceased, temporarily or permanently, shall be stabilized within 14 calendar days unless they are scheduled to and do resume within 21 calendar days. The entire limits of construction will be reseeded once construction is complete. The Avallon, Building I 10415 Morado Circle, Suite 200 Austin, Texas 78759 512.349.0700 • 512.349.0727 fax www.cpyi.com Permanent Stormwater Section for Regulated Activities on the Edwards Aquifer Recharge Zone and Relating to 30 TAC §213.5(b)(4)(C), (D)(Ii), (E), and (5), Effective June 1, 1999 REGULATED ENTITY NAME: Old Settlers Blvd Intersection Improvements Permanent best management practices (BMPs) and measures that will be used during and after construction is completed. 1. X Permanent BMPs and measures must be implemented to control the discharge of pollution from regulated activities after the completion of construction. 2. X These practices and measures have been designed, and will be constructed, operated, and maintained to insure that 80% of the incremental increase in the annual mass loading of total suspended solids (TSS) from the site caused by the regulated activity is removed. These quantities have been calculated in accordance with technical guidance prepared or accepted by the executive director. X The TCEQ Technical Guidance Manual (TGM) was used to design permanent BMPs and measures for this site. A technical guidance other than the TCEQ TGM was used to design permanent BMPs and measures for this site. The complete citation for the technical guidance that was used is provided below: 3. X Owners must insure that permanent BMPs and measures are constructed and function as designed. A Texas Licensed Professional Engineer must certify in writing that the permanent BMPs or measures were constructed as designed. The certification letter must be submitted to the appropriate regional office within 30 days of site completion. 4. N/A Where a site is used for low density single-family residential development and has 20 % or Tess impervious cover, other permanent BMPs are not required. This exemption from permanent BMPs must be recorded in the county deed records, with a notice that if the percent impervious cover increases above 20% or land use changes, the exemption for the whole site as described in the property boundaries required by 30 TAC §213.4(g) (relating to Application Processing and Approval), may no longer apply and the property owner must notify the appropriate regional office of these changes. This site will be used for low density single-family residential development and has 20% or less impervious cover. This site will be used for low density single-family residential development but has more than 20% impervious cover. X This site will not be used for low density single-family residential development. 5. N/A The executive director may waive the requirement for other permanent BMPs for multi- family residential developments, schools, or small business sites where 20% or less impervious cover is used at the site. This exemption from permanent BMPs must be recorded in the county deed records, with a notice that if the percent impervious cover increases above 20% or land use changes, the exemption for the whole site as described in the property boundaries required by 30 TAC §213.4(g) (relating to Application Processing and Approval), may no longer apply and the property owner must notify the appropriate regional office of these changes. TCEQ-0600 (Rev. 10/01/04) Page 1 of 3 ATTACHMENT A - 20% or Less Impervious Cover Waiver. This site will be used for multi -family residential developments, schools, or small business sites and has 20% or less impervious cover. A request to waive the requirements for other permanent BMPs and measures is found at the end of this form. This site will be used for multi -family residential developments, schools, or small business sites but has more than 20% impervious cover. X This site will not be used for multi -family residential developments, schools, or small business sites. 6. ATTACHMENT B - BMPs for Upgradient Stormwater. X A description of the BMPs and measures that will be used to prevent pollution of surface water, groundwater, or stormwater that originates upgradient from the site and flows across the site is identified as ATTACHMENT B at the end of this form. If no surface water, groundwater or stormwater originates upgradient from the site and flows across the site, an explanation is provided as ATTACHMENT B at the end of this form. If permanent BMPs or measures are not required to prevent pollution of surface water, groundwater, or stormwater that originates upgradient from the site and flows across the site, an explanation is provided as ATTACHMENT B at the end of this form. 7. ATTACHMENT C - BMPs for On-site Stormwater. X A description of the BMPs and measures that will be used to prevent pollution of surface water or groundwater that originates on-site or flows off the site, including pollution caused by contaminated stormwater runoff from the site is identified as ATTACHMENT C at the end of this form. If permanent BMPs or measures are not required to prevent pollution of surface water or groundwater that originates on-site or flows off the site, including pollution caused by contaminated stormwater runoff, an explanation is provided as ATTACHMENT C at the end of this form. 8. N/A ATTACHMENT D - BMPs for Surface Streams. A description of the BMPs and measures that prevent pollutants from entering surface streams, sensitive features, or the aquifer is provided at the end of this form. Each feature identified in the Geologic Assessment as "sensitive" has been addressed. 9. X The applicant understands that to the extent practicable, BMPs and measures must maintain flow to naturally occurring sensitive features identified in either the geologic assessment, executive director review, or during excavation, blasting, or construction. X The permanent sealing of or diversion of flow from a naturally -occurring "sensitive" or "possibly sensitive" feature that accepts recharge to the Edwards Aquifer as a permanent pollution abatement measure has not been proposed for any naturally -occurring "sensitive" or "possibly sensitive" features on this site. ATTACHMENT E - Request to Seal Features. A request to seal a naturally - occurring "sensitive" or "possibly sensitive" feature, that includes a justification as to why no reasonable and practicable alternative exists, is found at the end of this form. A request and justification has been provided for each feature. 10. X ATTACHMENT F - Construction Plans. Construction plans and design calculations for the proposed permanent BMPs and measures have been prepared by or under the direct supervision of a Texas Licensed Professional Engineer. All construction plans and design information have been signed, sealed, and dated by the Texas Licensed Professional Engineer. Construction plans for the proposed permanent BMPs and measures are provided at the end of this form. Design Calculations, TCEQ TCEQ-0600 (Rev. 10/01/04) Page 2 of 3 Construction Notes, all man-made or naturally occurring geologic features, all proposed structural measures, and appropriate details must be shown on the construction plans. 11. X ATTACHMENT G - Inspection, Maintenance, Repair and Retrofit Plan. A plan for the inspection, maintenance, repair, and, if necessary, retrofit of the permanent BMPs and measures is provided at the end of this form. The plan has been prepared and certified by the engineer designing the permanent BMPs and measures. The plan has been signed by the owner or responsible party. The plan includes procedures for documenting inspections, maintenance, repairs, and, if necessary, retrofits as well as a discussion of record keeping procedures. 12. X The TCEQ Technical Guidance Manual (TGM) was used to design permanent BMPs and measures for this site. N/A Pilot -scale field testing (including water quality monitoring) may be required for BMPs that are not contained in technical guidance recognized by or prepared by the executive director. N/A ATTACHMENT H - Pilot -Scale Field Testing Plan. A plan for pilot -scale field testing is provided at the end of this form. 13. X ATTACHMENT I -Measures for Minimizing Surface Stream Contamination. A description of the measures that will be used to avoid or minimize surface stream contamination and changes in the way in which water enters a stream as a result of the construction and development is provided at the end of this form. The measures address increased stream flashing, the creation of stronger flows and in -stream velocities, and other in -stream effects caused by the regulated activity which increase erosion that results in water quality degradation. Responsibility for maintenance of permanent BMPs and measures after construction is complete. 14. X The applicant is responsible for maintaining the permanent BMPs after construction until such time as the maintenance obligation is either assumed in writing by another entity having ownership or control of the property (such as without limitation, an owner's association, a new property owner or lessee, a district, or municipality) or the ownership of the property is transferred to the entity. Such entity shall then be responsible for maintenance until another entity assumes such obligations in writing or ownership is transferred. 15. X A copy of the transfer of responsibility must be filed with the executive director at the appropriate regional office within 30 days of the transfer if the site is for use as a multiple single-family residential development, a multi -family residential development, or a non-residential development such as commercial, industrial, institutional, schools, and other sites where regulated activities occur. 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 PERMANENT STORMWATER SECTION is hereby submitted for TCEQ review and executive director approval. The application was prepared by: Kelly Morrelli, P.E. (Agent) Print Name of Customer/Agent 1. 0 62/("(-'41--t-t ' 'OH 2_ Signature f Customer/Agent Date TCEQ-0600 (Rev. 10/01/04) Page 3 of 3 cp&y Partners for a Better Quality of Life Form TCEQ-0600 Attachments ATTACHMENT A - <20% IMPERVIOUS COVER WAIVER Not applicable. ATTACHMENT B - BMPS FOR UPGRADIENT STORMWATER Surface water runoff that originates upgradient of the Old Settlers Blvd improvements will follow its normal drainage path and be conveyed to and through the project the same as they are under existing conditions. Using PFC as a BMP will allow onsite TSS to be treated before leaving the roadway and mixing with offsite water. ATTACHMENT C — BMPS FOR ON-SITE STORMWATER Runoff from the proposed Old Settlers Blvd improvements will be treated using Permeable Friction Course (PFC) on the added impervious cover within City right-of- way. See attachments for design calculations. ATTACHMENT D — BMPS FOR SURFACE STREAMS Not applicable. ATTACHMENT E — SENSITIVE FEATURES FLOW/SEAL Not applicable. ATTACHMENT F — CONSTRUCTION PLANS Attached. ATTACHMENT H — PILOT -SCALE TESTING PLAN Not applicable. The Avallon, Building I 10415 Morado Circle, Suite 200 Austin, Texas 78759 512.349.0700 • 512.349.0727 fax www.cpyi.com cp&y Partners for a Better Quality of life ATTACHMENT G — INSPECTION, MAINT., REPAIR & RETROFIT PLAN Attached. ATTACHMENT I — MEASURES FOR MINIMIZING SURFACE STREAM CONTAMINATION Surface stream contamination will be minimized through the use of PFC. New impervious cover will be treated before leaving the roadway. The Availon, Building 1 10415 Morado Circle, Suite 200 Austin, Texas 78759 512.349.0700 • 512.349.0727 fax www.cpyi.com Form TCEQ-0600 ATTACHMENT G Maintenance Plan and Schedule for Permanent Erosion Controls Permeable Friction Course PROJECT NAME Old Settlers Blvd Intersection Improvements LOCATION On Old Settler's Blvd (FM 3406), east of Georgetown Railroad west of N. Mays Street. CITY, STATE ZIP PFC: Inspections Round Rock. Texas 78665 An annual inspection must be performed to determine that the PFC is achieving the necessary TSS removal. During the annual inspection a permeability test using the TxDOT Test Procedure Tex -246-F Part I must be performed. At least one such test must be performed for each mile of roadway in the project. If more than 100 seconds are required for the water to drain, maintenance must be performed on the pavement. Maintenance Maintenance of the pavement will consist of milling the old overlay, disposing of the used asphalt appropriately, and applying a new overlay in accordance with the guidelines specified in Section 3.4.16. A permeability test must be performed at the time of replacement to demonstrate that the new pavement has the required permeability. Documentation: All activity preformed on the PFC shall be maintained in one consolidated file which indicates, at minimum: • Inspection/Maintenance Date • Indication all items presented above have been checked • Description of any maintenance items provided • Expected date of next inspection Attachment G - Maintenance Plan Sheet 2 of 2 An amended copy of this document will be provided to the TCEQ within thirty (30) days of any changes in the following information. Responsible Party for Maintenance City of Round Rock Contact Person Address City, State Zip Telephone Number Signature of Responsible Party Steve Norwood 221 E. Main Street Round Rock. Texas 78664 Attachment G - Maintenance Plan Sheet 2 of 2 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 City of Round Rock, Texas Corporation/Partnership/Entity Name have authorized Kelly Morrelli, P.E. Print Name of Agent/Engineer of CP&Y, 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) Page 1 of 2 An amended copy of this document will be provided to the TCEQ within thirty (30) days of any changes in the following information. Responsible Party for Maintenance City of Round Rock Contact Person Address City, State Zip Telephone Number Signature of Responsible Party Attachment G - Maintenance Plan Steve Norwood 221 E. Main Street Round Rock. Texas 78664 512-218-5410 Sheet 2 of 2 Agent Authorization Form For Required Signature Edwards Aquifer Protection Program Relating to 30 TAC Chapter 213 Effective June 1, 1999 Steve Norwood Print Name City Manager Title - Owner/President/Other of City of Round Rock, Texas Corporation/Partnership/Entity Name have authorized Kelly Morrelli, P.E. Print Name of Agent/Engineer of CP&Y, 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) Page 1 of 2 24. Street Address of the Regulated Entity: (No P.O. Boxes) Located on Old Settlers Boulevard beginning 600 -ft west of Chisholm Trail Road and ending at N. Mays Street. 36. Nearest City County State Nearest ZIP Code City Williamson State 78665 ZIP 30.535 ZIP + 4 -97.692 Degrees 25. Mailing Address: City of Round Rock, c/o Steve Norwood Degrees 221 E. Main Street Seconds City Round Rock State TX ZIP 78664 ZIP + 4 5299 26. E -Mail Address: snorwood@round-rock.tx.us 27. Telephone Number 28. Extension or Code 29. Fax Number (if applicable) ( 512) 218-5410 Sludge ( 512) 218-7097 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) 1611 1611 237310 237310 34. What is the Primary Business of this entity? (Please do not repeat the SIC or NAICS description.) Construction of roadway improvements Questions 34 - 37 addressgeographic location. PI 35. Description to Physical Location: Located on Old Settlers Boulevard beginning 600 -ft west of Chisholm Trail Road and ending at N. Mays Street. 36. Nearest City County State Nearest ZIP Code Round Rock Williamson Tx 78665 37. Latitude (N) In Decimal: 30.535 38. Longitude (W) In Decimal: -97.692 Degrees Minutes Seconds Degrees Minutes Seconds 30 32 6 -97 41 31 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 guidance. • Dam Safety • Districts i4 Edwards Aquifer ■ Industrial Hazardous Waste • Municipal Solid Waste 512 ) 218-5410 Signature: Date: • New Source Review — Air ■ OSSF • Petroleum Storage Tank • PWS ■ Sludge • Stormwater • Title V — Air ■ Tires ■ Used Oil 1 Utilities • Voluntary Cleanup • Waste Water ■ Wastewater Agriculture • Water Rights • Other: SECTION IV: Preparer Information 40. Name: Kelly Morrelli, P.E. CP&Y, Inc. 41. Title: 42. Telephone Number 43. Ext./Code Project Engineer 44. Fax Number 45. E -Mail Address ( 512 ) 349-0700 126 ( 512) 349-0727 kmorrelli@cpyi.com 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 this form.) Company: City of Round Rock Job Title: City Manager Namepn Print) : Steve Norwood Phone: ( 512 ) 218-5410 Signature: Date: TCEQ-10400 (09/07) Page 2 of 2