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First Baptist-CS04111711,'24/2004 12:27 FA~ 9722389171 STARIANG RICHARDSON ~002 I. Notice of!Termination (NOT) for Sto.rm TCEQ Office Use Only Water D schar.g, es Associated w,th TPDES Permit Number: TXR15-_- ........ NO Constructton Activity under the TPDE$ GIN Number: fCEQ Construction General Permit (TXR150000) For help comple[in§ this applicaaon, read the TXR150000 NOI InstnJctions (TC~(~-20023 A. TPDES Permit Number: T×R15 6379 . B. Construction Site Operator Customer Reference Number: CN Name: Starling Richardson Construction, inc. Mailing Address: 1201 Kas Drive, Suite D City: Richardson Country Mailing Information (if outside USA) Territory: Phone Number: 972-238-8131 Extension: E-mail Address: src st rn richar on.corn State: TX Country Code: Fax Number: Zip.Code: 75081 Postal Code: g72-238-9171 C. Project / Site information Regulated Entity Reference Number: RN Name: New Worship Center for First Baptist Church Physical Address: 590 S. Dentol] Tap Road, Coppe]_]_. Ts×as 750[7 Location Access Description: First BaPtist Church. Col~Dell, TX; Volume 72014. Parle 1026-Deed Records of Dallas, City:~ County: DALLAS _ Zip Code: 75019 D. Contact _ if the TCEQ needs additionat information regarding this termination, who should be contacted? Name: James B. Starlin~ Title: Presider~t Phone Number: 972-238-8131 Extension: Fax Number: 972-238-9171 E-mail Address: jim~i!_starlinflrichardson-com Certification I certify under penalty of law that authorization under the TPDES Construction General Permit (TXR150000) is no longer necessary based on the provisions of the general permit. I understand that by submitting this Notice of Termination, I am no longer authorized to discharge storm water associated with construction activity under the general permit TXR150000, and that discharging pollutants in storm water associated with construction activity to waters of the U.S. is unlawful under the Clean Water Act where the discharge is not authorized by a TPDES permit. I also understand that. the submittal of this Notice of Termination does not release an operator from liability for any violations of this permit or the Clean Water Act. Construction Site Operator Representative: Prefix: Mr. First: James Middle: B. Last: Starlin.q Suffix: Title: President Signature: ~..,r.~,,.~ ~. jT~_.~ Date: If you have questions o~n ~ow to fill out this form/or about the storm water program, please contact us at (512) 239-4671. Individuals are entitled to request and review their personal information that the agency gathers on its forms. They may atso have any errors in their information corrected. To review such information, contact us at (512) 239-3282. The completed NOT must be mailed to the following address: Texas Commission on Environmental Quality Storm Water & General Permits Team; MC - 228 P.O. Box 13087 Austin, Texas 78711-3087 ~l'l CI~Q- 20023 (02/03) Page t of I