Loading...
Fresenius-PT140117 Logistics Center t Attachment 3 MEM -4411111111111■ rrrr s r� OMB ammo arm I rr w LARGE CONSTRUCTION SITE NOTICE FOR THE Texas Commission on Environmental Quality(TCEQ) Storm Water Program TPDES GENERAL PERMIT TXR150000 "SECONDARY OPERATOR" NOTICE This notice applies to construction sites operating under Part ILE.3. of the TPDES General Permit Number TXRI50000 for discharges of storm water runoff from construction sites equal to 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.This notice shall be posted along with a copy of the signed Notice of Intent(NOI),as applicable. Additional information regarding the TCEQ storm water permit program may be found on the Internet at:http:l/www.tceq.state.tx.usinavlpertnitsisw permits.html Site Specific TPDES Authorization Number: N/A Operator Name: Dallas/Fort Worth International Airport Patricia Luse Contact Name&Phone Number: Dallas/Fort Worth International Airport 972-973-5560 Logistics Center 1 Project Description:Physical address or description Located approximately 1 mile northwest of the intersection of IH of the site's location, and estimated start date and 635 and Royal Lane. projected end date, or date that disturbed soils will Coppell,Texas be stabilized. Estimated Start Date:01-01-2014 Estimated Completion Date:08-31-2014 Location of Storm Water Pollution Prevention Plan (SWP3): Construction Trailer For Large Construction Activities Authorized Under Part II.E.3.(Obtaining Authorization to Discharge)the following certification must be completed: Jim Crites (Typed or Printed Name of 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 of this permit. A storm water 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 possibility of fine and imprisonment for knowing violations. Signature and Title. Date: 1 i 1 -1 Y Date Notice Removed MS4 operator notified per Part II.F.3. Capitol Environmental,Inc. Austin,San Antonio (817)719-2847 -42- Houston,DFW Copyright 0 2004 Capitol Environmental Abilene Logistics Center 1 Attachment 3 inims gamer nrr MIN UMW = WV LARGE CONSTRUCTION SITE NOTICE FOR THE Texas Commission on Environmental Quality(TCEQ) Storm Water Program TPDES GENERAL PERMIT TXR150000 "SECONDARY OPERATOR" NOTICE This notice applies to construction sites operating under Part II.E.3. of the TPDES General Permit Number TXR150000 for discharges of storm water runoff from construction sites equal to 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.This notice shall be posted along with a copy of the signed Notice of Intent(NOl),as applicable.Additional information regarding the TCEQ storm water permit program may be found on the internet at:http:I/www.tceq.state.tx.us/nav/permits/sw permits.html Site Specific TPDES Authorization Number: N/A Operator Name: Logistics Center 1/A Delaware Limited Liability Company Mark Busby Contact Name&Phone Number: Capitol Environmental, Inc. 817-719-2847 Logistics Center 1 Project Description:Physical address or description Located approximately 1 mile northwest of the intersection of IH of the site's location, and estimated start date and 635 and Royal Lane. projected end date, or date that disturbed soils will Coppell,Texas be stabilized. Estimated Start Date:01-01-2014 Estimated Completion Date:08-31-2014 Location of Storm Water Pollution Prevention Plan Construction Trailer (SWP3): For Large Construction Activities Authorized Under Part n.E.3.(Obtaining Authorization to Discharge)the following certification must be completed: Pat Perot (Typed or Printed Name of 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 of this permit. A storm water 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 possibility of fine and imprisonment for knowing viol• '• s. � / Signature and Title: �/,� • v� Date: d l JI-3 j j,/ ` Date Notice Removed MS4 operator notified per Part ILF.3. Capitol Environmental,Inc. Austin,San Antonio (817)719-2847 -41- Houston,DFW Copyright©2004 Capitol Environmental Abilene Texas Commission on Environmental Quality Construction Notice of Intent Site Information (Regulated Entity) What is the name of the site to be authorized? Logistics Center 1 Does the site have a physical address? No Because there is no physical address, Site is located approximately 1 mile northwest describe how to locate this site: of the intersection of IH 635 and Royal Lane. City Coppell State TX ZIP 75063 County DALLAS Latitude(N)(##.######) 32.95203 Longitude(W)(-###.######) -97.02758 Primary SIC Code 1542 Secondary SIC Code Primary NAICS Code Secondary NAICS Code Regulated Entity Site Information What is the Regulated Entitys Number(RN)? What is the name of the Regulated Entity(RE)? Logistics Center 1 Does the RE site have a physical address? No Because there is no physical address, Site is located approximately 1 mile northwest describe how to locate this site: of the intersection of IH 635 and Royal Lane. City Coppell State TX ZIP 75063 County DALLAS Latitude (N)(##.######) 32.95203 Longitude(W)(-###.######) -97.02758 What is the primary business of this entity? Non-Residential Structures HILLWOO-Customer (Applicant) Information How is this applicant associated with this site? OPERATOR What is the applicant's Customer Number CN602465494 (CN)? Type of Customer Partnership Full legal name of the applicant: Legal Name HILLWOOD CONSTRUCTION SERVICES LP Texas SOS Filing Number 014254610 Federal Tax ID 752908860 State Franchise Tax ID DUNS Number Number of Employees 0-20 Independently Owned and Operated? No l certify that the full legal name of the-entity Yes applying for this permit has been provided and is legally authorized to do business in Texas. Responsible Authority Contact Organization Name HILLWOOD CONSTRUCTION SERVICES LP Prefix First Greg Middle Last Edwards Suffix Title Operations Manager Responsible Authority Mailing Address Enter new address or copy one from list: Address Type Domestic Mailing Address (include Suite or Bldg.here,if Victory Park 3090 Olive Street Suite 300 applicable) Routing (such as Mail Code,Dept.,orAttn:) City Dallas State TX ZIP 75219 Phone (###-###-####) 9722012930 Extension Alternate Phone(###-###-####) Fax(###-###-####) E-mail Application Contact Person TCEQ should contact for questions about this application: Same as another contact? HILLWOOD CONSTRUCTION SERVICES LP Organization Name HILLWOOD CONSTRUCTION SERVICES LP Prefix First Greg Middle Last Edwards Suffix Title Operations Manager Enter new address or copy one from list: HILLWOOD CONSTRUCTION SERVICES LP Mailing Address Address Type Domestic Mailing Address (include Suite or Bldg.here,if Victory Park 3090 Olive Street Suite 300 applicable) Routing(such as Mail Code,Dept.,orAttn:) City Dallas State TX ZIP 75219 Phone(###-###-####) 9722012930 Extension Alternate Phone(###-###-####) Fax(###-###-####) E-mail CNOI General Characteristics 1)Is the project located on Indian Country No Lands? 2)Is your construction activity associated with a No facility that,when completed,would be associated with the exploration,development, or production of oil or gas or geothermal resources? 3)What is the Primary Standard Industrial 1542 Classification (SIC)Code that best describes the construction activity being conducted at the site? 4)If applicable,what is the Secondary SIC Code(s)? 5)Is the project site part of a larger common No plan of development or sale? 6)What is the total number of acres disturbed? 60 7)What is the name of the first water body(s)to Grapevine Creek receive the stormwater runoff or potential runoff from the site? 8)What is the segment num ber(s)of the 0822 classified water body(s)that the discharge will eventually reach? 9)Is the discharge into an MS4? Yes 9.1.What is the name of the MS4 Operator? CityofCoppell 10)Are any of the surface water bodies No receiving discharges from the construction site on the latest EPA-approved CWA303(d)List of impaired waters? 11)Is the discharge or potential discharge No within the Recharge Zone,Contributing zone, or Contributing zone within the Transition zone of the Edwards Aquifer,as defined in 30 TAC Chapter 213? 12)I certify that a stormwater pollution Yes prevention plan has been developed,will be implemented prior to construction,and to the best of my knowledge and belief is compliant with any applicable local sediment and erosion control plans,as required in the general permit TXR150000.Note:For multiple operators who prepare a shared SWP3,the confirmation of an operator maybe limited to its obligations under the SWP3 provided all obligations are confirmed by at least one operator. 13)I certify that I have obtained a copy and Yes understand the terms and conditions of the Construction General Permit(TXR150000). 14)I understand that a Notice of Termination Yes (NOT)must be submitted when this authorization is no longer needed. Certification 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 Greg S Edwards, the owner of the STEERS account ER026119. 2. I have the authority to sign this data on behalf of the applicant named above. 3. I 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. I 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. I understand that use of my password constitutes an electronic signature legally equivalent to my written signature. 6. I 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. I 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. I 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: Greg S Edwards OPERATOR Account Number: ER026119 Signature IP Address: 160.109.97.52 Signature Date: 2014-01-15 Signature Hash: 8CB24E49EBE09431COA2EOF613A7850F86A2988C9A22044AD99CA00F18D7D45F Form Hash Code at 7544657118CB5DBF870AFOA5FOFE3D3364161 F6450A242671AAE8931A9541 B5F time of Signature: Fee Payment Transaction by: The application fee payment transaction was made by ER026119/Greg S Edwards Paid by. The application fee was paid by GREG S EDWARDS Fee Amount: $225.00 Paid Date: The application fee was paid on 2014-01-15 TransactionNoucher number: The transaction number is 582EA000158166 and the voucher number is 198831 Submission Reference Number: The application reference number is 79057 Submitted by The application was submitted by ER004792/Casey M Friaell Submitted Timestamp: The application was submitted on 2014-01-15 at 13:03:16 CST Submitted From: The application was submitted from IP address 97.77.69.78 Confirmation Number: The confirmation number is 80351 Steers Version: The STEERS version is 5.94 Additional Information Application Creator:This account was created byCaseyM Frizzell