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CONSTRUCTION SITE NOTICE
FOR THE
Texas Commission on Environmental Quality (TCEQ)
Storm Water Program
TPDES GENERAL PERMIT TXR150000
The following information is posted in compliance with Part II.D.2. of the TCEQ General Permit Number
TXR150000 for discharges of storm water runoff from construction sites. Additional information regarding the
TCEQ storm water permit program may be found on the internet at:
http: / /www.tceq.state.tx.us/ permitting /water quality /stormwater/TXR15 AIR.html
Contact Name and Phone Number: Jason Gaiko 972 -292 -7660
East of Beltline Road and North of interstate Highway 635 Dallas,
Project Description: Texas
(Physical address or description of the site's
location, estimated start date and projected end
date, or date that disturbed soils will be
stabilized)
Location of Storm Water Pollution Job Office
Prevention Plan :
For Construction Sites Authorized Under Part II.D.2. (Obtaining Authorization to Discharge) the following
certification must be completed:
I Jason Gaiko (Typed or Printed Name Person Completing This Certification) certify under penalty of
law that I have read and understand the eligibility requirements for claiming an authorization under Part II.D.2. of
TPDES General Permit TXR150000 and agree to comply with the terms of this permit. A storm water pollution
prevention plan has been developed and implemented according to permit requirements. A copy of this signed
notice is supplied to the operator of the MS4 if discharges enter an MS4 system. I am aware there are significant
penalties for providing false information or for conducting unauthorized discharges, including the possibility of fine
and i ris n nt for knowing violations. 1.
Sign tune and Title Date