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LARGE CONS 1�`R CTIcL N SITE NOTILC -1/
TOR THE
Texas Commission on Environmental Quality (TCEQ)
Storm Water Program
TPDES GIVE AL PE IIT '1'X2150000
"PRIMARY OPERA TOR"NOTICE
This notice applies to constniction sites operating under Part II.E.3. of the TPDES General Permit Number
TXR150000 for discharges of stonnwater runoff from construction sites equal to or greater than five acres,
including the larger comnon plan of development. The information on this notice is required in Part III.E.2.
of the general permit. This notice shallbe posted along with a copy of the signed Notice of Intent (N0I), as
applicable. Additional iufonnation regarding the TCEQ storm water permit program maybe found on the
internet at: littp://Nvww..teeg.state.tx.us/Day/Veniiits/sxv ne�
Site - Specific TPDES Authorization Number:
Operator Name:
C� 1� t; fj1JSC � 11-AC
Contact Name and Phone Number:
Project Description: Physical address or description of the
site -s location, mid estimated start elate andprojected end
elate, or date that disturbeel soils »pill be stabilized.
I-AU_Rs -M
I:ocation of Storm Water Pollution Prevention Plan:
LARGE CONSTRUCTION SITE NOTICE
TOR THE
Texas Commission on Environmental Quality (TCEQ)
Storm Water Program
TPDES GENERAL PERMIT TXR150000
"SECONDARY OPERATOR " NOTICE
This notice applies to secondary operators of construction sites operating under Part II.E.3. of the TPDES
General Permit Number TXR150000 for discharges of storm water runoff from construction sites equalto or
greater than five acres, including the larger common plan of development. The information on this notice is
required in Part III.E.2. of the general permit. Additional information regarding the TCEQ storm water
permit program maybe found on the internet at: bttp://Nvww.tceq.state.tx.us/nay/periiiits/s-%v pennits.htnil
Activities Authorized Under Part II.E.3. (Obtaining Authorization to Discharge) the
followgg certification must be completed:
I ffbbtt e. C- U19A4—K�• (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.E.2. of TPDES General
Permit TXR150000 and agree to comply with the terms ofthis permit. A stormwater pollution prevention plan has been developed
and will be implemented prior to construction, according to permit requirements. A copy of this signed notice is supplied to the
operator of the MS4 if discharges enter an MS4. I am aware there are significant penalties for providing false information or for
conducting unauthorized discharges, including the possibAity of fine and imprisonment for knowing violations.
Signature and
SMDate � Z S
Date Notice Removed
MS4 operator nodfred per Part H.F.3.
Site - Specific TPDES Authorization Number:
r,? ,
Operator Name:
�"�" kLA
Contact Name and Phone Number:
Project Description: Physical address or description of the
site-w location, and estimated start date and projected end
date, or date that disturbed soils wilt be stabilized.
2c�L�
-Df \l.LF6
``_ :e-
Location of Storm Water Pollution Prevention Plan (SWP3):
Activities Authorized Under Part II.E.3. (Obtaining Authorization to Discharge) the
followgg certification must be completed:
I ffbbtt e. C- U19A4—K�• (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.E.2. of TPDES General
Permit TXR150000 and agree to comply with the terms ofthis permit. A stormwater pollution prevention plan has been developed
and will be implemented prior to construction, according to permit requirements. A copy of this signed notice is supplied to the
operator of the MS4 if discharges enter an MS4. I am aware there are significant penalties for providing false information or for
conducting unauthorized discharges, including the possibAity of fine and imprisonment for knowing violations.
Signature and
SMDate � Z S
Date Notice Removed
MS4 operator nodfred per Part H.F.3.