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ST9905-CS090204 r Copy of Record - Texas Commission on Environmental Quality - www.tceq.state.tx.us Page 1 of3 571'10 ( Texas Commission on Environmental Quality Construction NOI Notice of Termination TXR 15GS72 Today's date is: 2009-02-04 '. Customer (Applicant) Identification What is the applicant's Customer Number (CN)? Type of Customer Texas SOS Filing Number Prefix Legal Name Suffix Federal Tax 10 State Franchise Tax 10 DUNS Number Number of Employees Independently Owned and Operated? CN600426225 Corporation 5138606 TISEO PAVING CO 382209998 13822099985 21-100 Yes r-- Regulated Entity Identification What is the Regulated Entity's Number (RN)? What is the name of the Regulated Entity (RE)? RN105269948 Does the RE site have a physical address? Because there is no physical address, describe how to locate this site: TISEO PAVING ROADWAY & DRAINAGE IMPROV BETHEL ROAD I & BASS PRO DRIVE No r--- City State ZIP County Latitude (N) (##.######) Longitude 0N) (-###.######) What is the primary business of this entity? Primary SIC Code Secondary SIC Code Primary NAICS Code Secondary NAICS Code ON BETHEL RD FROM CITY LIMIT TO FREEPORT PKWY & BASS PRO DR FROM SH 121 N FRONTAGE RD TO COPPELL CITY LIMITS COPPELL TX 75019 TARRANT 32.95472 -97.01083 1611 Customer (Applicant) Address & Phone https://www9.tceq.state.tx.us/ePermitsExtemal WEB/faces/i soPalZes/ConvOfR P.r.()T(fR pnnrt ; ') IA r>n(\n Copy of Record - Texas Commission on Environmental Quality - www.tceq.state.tx.us Page 3 of3 r--- fine and imprisonment for knowing violations. 1. I am Louie Tiseo OPERATOR 2. I have protected my accounUpassword and am in full complaince with the electronic signature submitted to receive account ER012996. 3. I have the authority to submit this data on behalf of the operator of the storm water discharge site named above. 4. This action constitutes an electronic signature equivalent to my written signature. 5. I am knowingly and intentionally signing Construction NOI Notice of Termination TXR15GS72. 6. My signature indicates that I am in agreement with the information on this form, and authorize its submittal to the TCEQ. ~ OPERATOR Signature: Louie Tiseo OPERATOR Account Number: ER012996 Signature IP Address: 216.201.216.170 Signature Date: 2009-02-04 Signature AEOF AF078EF177E8D78FF687 A36A7157D262CF2F88E25036E5BE2A411 CAC 17D8 Hash: Form Hash DBF31 F8642359076AA656EEC914C6E89084D891 FOBEEC7D1 B50A9A80676C1 DE6 Code at time of Signature: Submission Reference Number: The application reference number is 13020 The application was submitted by ER012996/Louie Tiseo The application was submitted on 2009-02-04 at 07:13:31 CST The application was submitted from IP address 216.201.216.170 The confirmation number is 29816 The STEERS version is 5.51 The permit number is TXR15GS72 Submitted by: Submitted Timestamp: Submitted From: Confirmation Number: Steers Version: Permit Number: Additional Information Application Creator: This account was created by Louie Tiseo r-- https://www9.tceq.state. tx. us/ePermitsExtemalWEB/faces/ispPages/CopvOfRecordReDort. i... 2/4/2009 Copy of Record - Texas Commission on Environmental Quality - www.tceq.state.tx.us Page 2 of3 ~ ------- What is the applicant's role with the RE? What date did this applicant begin any regulated activity at this site? If in the future, enter today's date. (mm/dd/yyyy) Mailing Address (include Suite or Bldg. here, if applicable) Routing (such as Mail Code, Dept., or Attn:) City State ZIP If Outside U.S.: Foreign Postal Code and Country Phone (ttfffl ###"####) Extension Fax (ttfffl ttfffl .####) E-mail Mailing Address (include Suite or Bldg. here, if applicable): Routing (such as Mail Code, Dept., or Attn:): City: State: ZIP: If Outside U.S.: Foreign Postal Code: and Country: Phone: (###-#l#f.-####) Extension: Fax: (ttfffl ttfffl 1ttHHt) E-mail: Operator 03/23/2007 PO BOX 270040 DALLAS TX 75227 UNITED STATES 9722890723 9722165637 Construction Notice of Intent - Termination Reason What is the reason for terminating? (See instructions for descriptions of reasons.) Final stabilization has been achieved. Certificatio n I certify that I am authorized under 30 Texas Administrative Code '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 https://www9.tceq.state.tx. us/ ePermitsExtemaIWEB/faces/i sDPa!:!es/CoDvOfRecordRenort. i... 2/4/2009 r---. Buddy Garcia, Chairman Larry R. Soward, Commissioner Bryan W. Shaw, Ph.D., Commissioner Mark R. Vickery, P.G., Executive Director TEXAS COMMISSION ON ENVIRONMENTAL QUALITY Protecting Texas by Reducing and Preventing Pollution TISEO PAVING CO PO BOX 270040 DALLAS, TX 75227 Re: TXR15GSn for the facility/project, RNl05269948, TISEO PAVING ROADWAY & DRAINAGE IMPROV BETHEL ROAD I & BASS PRO DRIVE Located at: ON BETHEL RD FROM CITY LIMIT TO FREEPORT PKWY & BASS PRO DR FROM SH 121 N FRONTAGE RD TO COPPELL CITY LIMITS COPPELL, TX 75019, TARRANT County Issued to: CN600426225, TISEO P A vn~G CO Dear Applicant: We have received your Notice of Termination of coverage under the general permit for discharge of stormwater for your facility at the location listed above. We have updated our records to show your termination of coverage request to be effective on February 4,2009 By signing this Notice of Termination, you are no longer authorized to discharge storm water associated with the activity under the general permit. Any discharge of pollutants in storm water associated with the activity to surface water in the state is unlawful under the Clean Water Act where the discharge is not authorized by a Texas Pollutant Discharge Elimination System (TPDES) permit. In addition, 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. As stated in the TPDES storm water general permit the Storm Water Pollution Prevention Plan and all data used to complete the NOI for coverage under the general permit, must be maintained and made readily available for review for a minimum period of three years following the termination date. Failure to comply with this or any permit condition is a violation of the permit and the statutes under which it was issued, and is grounds for enforcement action. If you have any questions related to processing you may contact the Storm Water Processing Center by email at SWPERMIT@tceq.state.tx.us or by telephone at (512) 239 3700. For technical issues, you may contact the storm water technical staff by email at SWGP@tceq.state.tx.us or by telephone at (512) 239-4671. Also, you may obtain information on the storm water web site at www.tceq.state.tx.us. Sincerely c/ffkP/S?-~ ,----.. L'Oreal W. Stepney, P.E., Director Water Quality Division P.O. Box 13087 . Austin, Texas 78711-3087 . 512/239-1000 . Internet address: www.tceq.state.tx.us