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E-Care Coppell- CS14219 laHILL &WILKINSON GENERAL CONTRACTORS 2703 TELECOM PARKWAY/SUITE 120/ RICHARDSON, TEXAS 75082 214.299.4300 PHONE/ 214.299.4444 FAX Certification Form City of Dallas Storm Water Management Dallas Texas 75040 RE: E-Care Emergency Center at 330 S. Denton Tap Road in Coppell, Texas — Dallas County 75019 A duly authorized representative must be identified and must sign the following certification statement: This Statement shall certify the following: • Storm Water Pollution Prevention Plan • Endangered Species Report • Historical Preservation Report • Soils Report 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. Owner/Operational Control Name: W/fit/ 4 A• 5 )lilt' Title: /191t/viccee Signature ,2' Date: fa), 20, 2004 FOR SCMOB 330 S Denton Tap, LLC Name of Company/Agency Contractor/Day to Day Control Name: Paul Dris oll C Titl +ai:,, xecutive Officer Signature _. Date: February 19, 2014 FOR Hill &Wilkinson Construction Group, Ltd. ODI www.hill-wilkinson.com td HILL &WILKINSON GENERAL CONTRACTORS 2703 TELECOM PARKWAY/SUITE 120/ RICHARDSON, TEXAS 75082 214.299.4300 PHONE/ 214.299.4444 FAX February 19, 2014 Executive Director Via Certified Mail Article No. 7012 3050 0002 2069 5413 TCEQ Return Receipt Requested C/o Storm Water& Pretreatment Team Mail Code 228 P.O. Box 13087 Austin, Texas 78711-3087 Attn: Storm Water and General Permits Team Small Construction Site— E-Care Emergency Center 330 S. Denton Tap Road Coppell, Texas—Dallas County 75019 TPDES Storm Water General Permit No. TXR 150000—Small Construction Site Delegating an "Authorized Representative"— Effective March 5, 2013 Dear Executive Director: This letter is submitted pursuant to 30 TAC §305.128 and serves to designate the individual who occupies the named position below as authorized to sign reports, storm water pollution prevention plans, certifications or other information requested by the Director or required by the permit. I understand that the signatory delegation does not extend to Notice of Intent ("NOI") Forms, Notice of Termination ("NOT") Forms, Notice of Change ("NOC") Letters, and Construction Site Notices. The individual who occupies the following position is hereby authorized to sign reports and other information addressed by Part VI1.6 of TPDES General Permit TXR150000, effective March 5, 2013: Billy Haley - Project Superintendent February 24, 2014 Through April 1, 2014 By signing this authorization, I confirm that I am a responsible corporate officer for Hill &Wilkinson Construction Group, Ltd. pursuant to 30 TAC §305.44 (a) (1) and provide the following certification required by this rule: For a corporation: by a responsible corporate officer. For the purpose of this section,a responsible corporate officer means:a Chief Executive Officer,secretary,treasurer,or vice-Chief Executive Officer of the corporation in charge of a principal business function or any other person who performs similar policy or decision making functions for the corporation;or the manager of one or more manufacturing, production or operating facilities employing more than 250 persons or having gross annual sales or expenditures exceeding$25,000,000(in second quarter 1980 dollars)if authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures. For a partnership or sole proprietorship: by a general partner or the proprietor, respectively. For a municipality,State, Federal or other public agency: by either a principal executive officer or ranking elected official. For purposes of this section,a principal executive officer of a Federal agency includes(1)the Chief Executive Officer of the agency, or(2)a senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency(e.g. Regional Administrators of EPA). "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 .-nalties for submitting false information,including the possibility of fine and imprisonment for knowing violations." February 19,2014 Name— Title Date Paul Driscoll t4)www.hill-wilkinson.com S .ANDIAIN C 1T BRINGING CAPITAL TO REAL ESTATE INVESTMENT February 20, 2014 Executive Director Via Certified Mail Article No. 7012 3050 0002 2069 5413 TCEQ Return Receipt Requested C/o Storm Water& Pretreatment Team Mail Code 228 P.O. Box 13087 Austin, Texas 78711-3087 Attn: Storm Water and General Permits Team Small Construction Site— E-Care Emergency Center 330 S. Denton Tap Road Coppell, Texas— Dallas County 75019 TPDES Storm Water General Permit No. TXR 150000—Small Construction Site Delegating an "Authorized Representative"—Effective March 5, 2013 Dear Executive Director: This letter is submitted pursuant to 30 TAC §305.128 and serves to designate the individual who occupies the named position below as authorized to sign reports, storm water pollution prevention plans, certifications or other information requested by the Director or required by the permit. I understand that the signatory delegation does not extend to Notice of Intent("NOI") Forms, Notice of Termination ("NOT") Forms, Notice of Change ("NOC") Letters, and Construction Site Notices. The individual who occupies the following position is hereby authorized to sign reports and other information addressed by Part VII.6 of TPDES General Permit TXR150000, effective March 5, 2013: Hill &Wilkinson Construction Group, Ltd. - Project Superintendent By signing this authorization, I confirm that I am a responsible corporate officer for SCMOB 330 S Denton Tap, LLC pursuant to 30 TAC §305.44 (a) (1) and provide the following certification required by this rule: For a corporation: by a responsible corporate officer. For the purpose of this section,a responsible corporate officer means:a Chief Executive Officer,secretary,treasurer,or vice-Chief Executive Officer of the corporation in charge of a principal business function or any other person who performs similar policy or decision making functions for the corporation;or the manager of one or more manufacturing,production or operating facilities employing more than 250 persons or having gross annual sales or expenditures exceeding$25,000,000(in second quarter 1980 dollars)if authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures. For a partnership or sole proprietorship:by a general partner or the proprietor, respectively. For a municipality,State,Federal or other public agency:by either a principal executive officer or ranking elected official. For purposes of this section,a principal executive officer of a Federal agency includes(1)the Chief Executive Officer of the agency,or(2)a senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency(e.g. Regional Administrators of EPA). "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." ri/10.4a. a744014 nitelN9i62 February 20,2014 Name— Title Date 550 BAILEY, SUITE 255 • FORT WORTH,TEXAS 76107 • 817.289.2610 • FAX 817.289.2614 HILL &WILKINSON GENERAL CONTRACTORS 2703 TELECOM PARKWAY/SUITE 120/ RICHARDSON, TEXAS 75082 214.299.4300 PHONE/ 214.299.4444 FAX February 19, 2014 Executive Director Via Certified Mail Article No. 7012 3050 0002 2069 5413 TCEQ Return Receipt Requested C/o Storm Water& Pretreatment Team Mail Code 228 P.O. Box 13087 Austin, Texas 78711-3087 Attn: Storm Water and General Permits Team Small Construction Site— E-Care Emergency Center 330 S. Denton Tap Road Coppell, Texas— Dallas County 75019 TPDES Storm Water General Permit No. TXR 150000—Small Construction Site Delegating an "Authorized Representative"— Effective March 5, 2013 Dear Executive Director: This letter is submitted pursuant to 30 TAC §305.128 and serves to designate the individual who occupies the named position below as authorized to sign reports, storm water pollution prevention plans, certifications or other information requested by the Director or required by the permit. I understand that the signatory delegation does not extend to Notice of Intent("NOI") Forms, Notice of Termination ("NOT") Forms, Notice of Change ("NOC") Letters, and Construction Site Notices. The individual who occupies the following position is hereby authorized to sign reports and other information addressed by Part VIl.6 of TPDES General Permit TXR150000, effective March 5, 2013: Matthew Vea - Project Superintendent April 1, 2014 Through November 2014 By signing this authorization, I confirm that I am a responsible corporate officer for Hill &Wilkinson Construction Group, Ltd. pursuant to 30 TAC §305.44 (a) (1) and provide the following certification required by this rule: For a corporation: by a responsible corporate officer. For the purpose of this section, a responsible corporate officer means: a Chief Executive Officer,secretary,treasurer, or vice-Chief Executive Officer of the corporation in charge of a principal business function or any other person who performs similar policy or decision making functions for the corporation;or the manager of one or more manufacturing, production or operating facilities employing more than 250 persons or having gross annual sales or expenditures exceeding$25,000,000(in second quarter 1980 dollars)if authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures. For a partnership or sole proprietorship: by a general partner or the proprietor, respectively. For a municipality, State, Federal or other public agency: by either a principal executive officer or ranking elected official. For purposes of this section,a principal executive officer of a Federal agency includes(1)the Chief Executive Officer of the agency,or(2)a senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency(e.g. Regional Administrators of EPA). "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 enalties for submitting false information,.Including the possibility of fine and imprisonment for knowing violations." CalLQ— - 'EO February 19,2014 Name— Title Date i• Paul Driscoll A � www.hill-wilkinson.com t419 11111111111111Er "-41111=11MINIM Imo Immi N JIM IIIP NM ME SMALL CONSTRUCTION SITE NOTICE FOR THE Texas Commission on Environmental Quality (TCEQ) Stormwater Program TPDES GENERAL PERMIT TXR150000 The following information is posted in compliance with Part II.E.2. of the TCEQ General Permit Number TXR150000 for discharges of stormwater runoff from small construction sites. Additional information regarding the TCEQ stormwater permit program may be found on the internet at: http://www.tceq.state.tx.us/nav/permits/wq construction.html Operator Name: Hill&Wilkinson Construction Group, Ltd. Contact Name and Phone Number: BillyHaleySuperintendent 2/24/14 to 1 1 214878-6360 p 4/ / 4 aj ect Description: Physical address or A Building addition will consist of a the design and construction of and description of the site's location, estimated start approximate 10,000 square foot single story building,drive through and canopy as well associated pavements.on 1.32 acres date and projected end date, or date that disturbed soils will be stabilized Start Date:February 24,2014 Approximate Finish Date:November 2014 Location of Stormwater Pollution Prevention Plan: Jobsite Trailer located at 33o S.Denton Tap Road in Coppell,Texas 75019 in Dallas County For Small Construction Activities Authorized Under Part II.E.2. (Obtaining Authorization to Discharge) the following certification must be completed: Paul Driscoll I (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 of this 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 possibility of fine and imprisonment for knowing violations. Signature and Title Date February 19, 2014 C4�� Date Notice Removed MS4 operator notified per Part II.F.3. MIIIMP MIN 111101 71111111 MO BM SMALL CONSTRUCTION SITE NOTICE FOR THE Texas Commission on Environmental Quality (TCEQ) Stormwater Program TPDES GENERAL PERMIT TXR150000 The following information is posted in compliance with Part II.E.2. of the TCEQ General Permit Number TXR150000 for discharges of stormwater runoff from small construction sites. Additional information regarding the TCEQ stormwater permit program may be found on the internet at: http://www.tceq.state.tx.us/nav/permits/wq construction.html Operator Name: Hill&Wilkinson Construction Group,Ltd. Contact Name and Phone Number: Matthew Vea Superintendent Apr 1,2014 thru Nov.1,2014 214 878-7393 oject Description: Physical address or A Building addition will consist of a the design and construction of and description of the site's location, estimated start approximate 10,000 square foot single story building,drive through and canopy as well associated pavements.on 1.32 acres date and projected end date, or date that disturbed soils will be stabilized Start Date:February 24,2014 Approximate Finish Date:October 2014 Location of-Stormwater Pollution Prevention Plan: Jobsite Trailer located at 33o S.Denton Tap Road in Coppell,Texas 75019 in County For Small Construction Activities Authorized Under Part II.E.2. (Obtaining Authorization to Discharge) the following certification must be completed: Paul Driscoll I (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 of this 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 possibility of fine and imprisonment for knowing violations. r Signature and Title 0 _Date February 19, 2014 0 E-O Date Notice Removed MS4 operator notified per Part II.F.3.