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Royal Oaks-PT110920I Copy of Record - Texas Commission on Environmental Quality - www.tce... Page 1 of 5 Texas Commission on Environmental Quality Construction Notice of Intent Site Information (Regulated Entity) What is the name of the site to be Royal Oaks authorized? TX Does the site have a physical ' ress� No . Because there is no physical address, 200 block of East Sandy Lake Road describe how to locate this site: 32.9689 City : Coppell State TX _. ZIP 75119: . County DALLAS Latitude (N ). O 32.968 - Longitude (VV) (##.�) - 96.9882 Primary SIC Code 16'13 Secondary SIC Code Pnm6 ry NAILS Code' Secondary NAICS Code Regialatetl Eh i. y SiteJnformation, ; What is the Regulated Entity's Number (RN)? Does the RE site have a physical address? Na City Coppell State ` TX 'ZIP 75019 County :.< Latitude (N) (##.######) 32.9689 Longitude (1N) (-ff#) - 96.88:82 What is the primary business of this entity? Utility Construction CONATSE- Customer (Applicant) Information How is this applicant associated with this Operator site? https: / /www9.tceq. state. tx .us /ePermitsExtemalWEB /faces /jspPages /Copy0f .. 9/20/2011 Copy of Record - Texas Commission on Environmental Quality - www.tce... Page 2 of S State Franch se Taxb. . DUNS Number Number of Employees 2'5.1 -500 Independently Owned and Operated? No Responsible Authority Contact Organization Name CONATSER CONSTRUCTION TX Ll? Prefix CONATSER CONSTRUCTION TX LP First Brock Middle Brock Last Wuggins. Suffix Huggins Title Vice Presitlentf Responsible Authority Mailing Address Vice President Enter new address or.00py one from list CONATSER CONSTRUCTION. TX LP' Address Type Domestic Mailing Address ( include Suite or 81dg.. here, PO.BOX 15448 if a livable PO BOX 15448 Routing (such as Mail Code, Dept., or Attn:) City FORTWORTH State TX .ZIP.7fi119 : Phone 8175341743 Extension ' Alternate Phone (�) Fax (### ## ##1##) 8175344556 E -mail vicki @conatserconstruction.com Application Contact Person TCEQ should contact for questions about this application: Same as another canti3ctl . COiVATER C.OIVSTRLJCTION TX LP Organization Name CONATSER CONSTRUCTION TX LP Prefix First Brock Middle ; Last ._ Huggins suffix. Title Vice President Enter new adtlress or copy one from,lisf. CONATSER CONSTRUCTION. TX LP' Mailing Address Address Type Domestic Mailing Address (include Suite or Bldg. here, PO BOX 15448 https: / /www9.tceq. state, tx.us /ePermitsExtemalWEB /faces jspPages /Copy0f... 9/20/2011 Copy of Record - Texas Commission on Environmental Quality - www.tce... Page 3 of 5 if applicable) Reuting (such as Mail Code,Dept., or Attrt:) City FORT WORTH State: TX ZIP 76119 Phone'() 81:75341743:: Extension Alternate Phone, (##j FaxO 8175344556 E -mail urcki @conatseroonstruction . CNOI General Characteristics 1) Is the project located on Indian Country No Lands? 3) If applicable, what is the Secondary SIC Code? 41 Is the nroieet.stte r arf of a' larnpr nrim. mr 5) What is the total number of acres disturbed? 7) What is the segment number(s) of the 0822 classified water body receiving the discharges from the construction site? 8) Is the drscharge intro on'.MS4? Yes 8.a. What is the name of the MS4 Operator? City of Coppell Yes Certification https: / /www .state.tx.us /ePennitsExtemalVVEB /faces /jspPages /Copy0f .. 9/20/2011 10) Is the discharge or potential discharge No within the Recharge Zone, Contributing zone, or Contributing zone within the Transition zone of the Edwards Aquifer? 1 Z) i certify that I have obtained a copy and understand the terms and conditions of the Construction General Permit (TXR150000). Copy of Record - Texas Commission on Environmental Quality - www.tce... Page 4 of 5 I certify that I am authorized under 30 Texas Administrative Code Subchapter 305.44 to sign this document and can provide documentation in proof of such authorization upon request. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. 1. I am Brock Huggins, the owner of the STEERS account ER019889. 2. 1 have the authority to sign this data on behalf of the applicant named above. 3. 1 have personally examined the foregoing and am familiar with its content and the content of any attachments, and based upon my personal knowledge and/or inquiry of any individual responsible for information contained herein, that this information is true, accurate, and complete. 4. 1 further certify that I have not violated any term in my TCEQ STEERS participation agreement and that I have no reason to believe that the confidentiality or use of my password has been compromised at any time. 5. 1 understand that use of my password constitutes an electronic signature legally equivalent to my written signature. 6. 1 also understand that the attestations of fact contained herein pertain to the implementation, oversight and enforcement of a state and/or federal environmental program and must be true and complete to the best of my knowledge. 7. 1 am aware that criminal penalties may be imposed for statements or omissions that I know or have reason to believe are untrue or misleading. 8. 1 am knowingly and intentionally signing Construction Notice of Intent. 9. My signature indicates that I am in agreement with the information on this form, and authorize its submittal to the TCEQ. OPERATOR Signature: Brock Huggins OPERATOR Account Number: ER019889 Signature IR Address: 163.234.25.21 Signature Date: 2011 -09 -20 Signature flash: 3 BAF 5 E 3 D 2 204ED20EBBC7299E9CFCEF0334129FAB83EBOBDO6E67E451 FBA4152 Form Hash Code at 311961A2F73F53D7E0729440AB1 B1 ECB61 OAl BF59DO09A2D75459D8964252BD1 time of Signature: Fee Payment Transaction by: The application fee payment transaction was made by ER019889 /Brock Huggins Paid b}i 7 he,application fee was paid by BROCK HUGG.INS Fee Amount: 225 Paid Date; The app flee was paid on 2011 09 -20 Transaction/Voucher number: The transaction number is 582EA000105517 and the voucher number is 136403 Submission Reference Number: The application reference number is 36980 Submitted by: The application:was submitted by ER0198891Brock Huggins Submitted Timestemp: The application was submitted on 2011-09 - 20 at 09:39:33 CDT IC https: / /www9. tceq. state. tx.us /ePermitsExtemal WEB /face s/j snPages /Copy0f... 9/20/2011 Copy of Record - Texas Commission on Environmental Quality - www.tce... Page 5 of 5 adtlress 163:234.25.21. .. Confirmation Number: The confirmation number is 46854 S #ears Version: , The STEERS.'ver5ion is Additional Information Application Creator: This account was created by Brock Huggins http s: / /www9.tceq. state .tx.us /ePerTnitsExtemalWEB /faces /j spPages /Copy0f... 9/20/2011