Loading...
FolderNO. 1 2 3 4 5 6 1 2 3 4 5 6 7 8 9 10 Engineer's Cost Estimate CREEK MEADOWS -SECTION 7, PHASE TWO PA YING, DRAINAGE, & UTILITY IMPROVEMENTS COLLEGE STATION, BRAZOS COUNTY, TEXAS DESCRIP,TION · QUANTITY · UNIT· EROSION CONTROL MEASURES Clearing & Grubbing (ROW, All Easements, & Areas 1 LS Requing Site Cut or Fill) Silt Fencing 4,150 LF Inlet Protection Barrier 9 EA Rock Rip-Rap (Located at Street Terminus) 2 EA Hydro-Seeding & Temporary Above-Ground 1 LS Irrigation System Miscellaneous Erosion Control Measures (i.e. Concrete 1 LS Wash-Out, Construction Entrance, Sand Bags, etc ... } UNlT ··cosr , $8,500.00 $1 .50 $250.00 $750.00 $6,500.00 $1,800.00 TOTAL , COST $8,500.00 $6,225.00 $2,250.00 $1 ,500.00 $6,500.00 $1,800.00 SUB-TOTAL= $26,775.00 PAVING IMPROVEMENTS Mobilization, Construction Staking, All Required 1 Testing by Contractor & Trench Safety In-Place Earthwork Excavation (Street Construction) 67 In-Place Compacted Earthwork Embankment 1,818 (Street Construction) Excavated On-Site 4" Thick Reinforced Concrete Sidewalk (Includes 20,544 H/C Ramps) 6"Raised Concrete Curb & Gutter 133 24" Laydown Concrete Gutter 4,983 Concrete Street Apron (6" Thick) 379 6" Compacted Lime Stabilized Subgrade (All 10,065 Streets) 6" Compacted Limestone Base (Residential Street) 7,188 2" Compacted Hot-mix Asphaltic Concrete 7,188 (Residential Street) DRAINAGE IMPROVEMENTS ' Mobilization, Construction Staking, All Required Testing I (Including TV) by Contractor & Trench Safety LS $8,500.00 $8,500.00 CY $5.00 $335.00 CY $5.50 $9,999.00 SF $4.25 $87,312.00 LF $11 .25 $1 ,496.25 LF $11 .50 $57,304.50 SY $48.00 $18, 192.00 SY $4.75 $47,808.75 SY $11 .00 $79,068.00 SY $13.00 $93,444.00 SUB-TOTAL= $403,459.50 $7,500.ool $7,500.00 CD1-260-0552-E03.xlsx 1of5 Engineer's Cost Estimate 2 Recessed Curb Inlet (5' Opening) 2 EA $4,700.00 $9,400.00 3 Recessed Curb Inlet (10' Opening) 2 EA $5,400.00 $10,800.00 4 Recessed Curb Inlet (15' Opening) 1 EA $6,500.00 $6,500.00 5 Recessed Curb Inlet (20' Opening) 2 EA $7,400.00 $14,800.00 6 Storm Sewer Junction Box (All Sizes) 1 EA $3,400.00 $3,400.00 7 4' Wide Concrete Pilot Channel 1,497 SF $8.00 $11,976.00 8 6:1 SET (18" Pipe) 2 EA $1,300.00 $2,600.00 9 Concrete Headwall & Wingwall w/Dissapater Blocks 3 EA $3,500.00 $10,500.00 (30" Pipe) 10 18" RCP (CL 4) Storm Sewer w/Cement Stabilized 80 LF $95.00 $7,600.00 Sand Bedding & Structural Backfill 11 24" RCP (CL 3) Storm Sewer w/Structural Backfill 182 LF $100.00 $18,200.00 12 24" RCP (CL 4) Storm Sewer w/Structural Backfill 35 LF $113.00 $3,955.00 13 30" ADS (N-12) Storm Sewer w/Cement Stabilized 269 LF $122.00 $32,818.00 Sand Bedding & Non-Structural Backfill 14 30" RCP (CL 3) Storm Sewer & Non-Structural 46 LF $122.00 $5,612.00 Backfill 15 30" RCP (CL 3) Storm Sewer & Structural Backfill 72 LF $135.00 $9,720.00 16 30" RCP (CL 4) Storm Sewer & Structural Backfill 70 LF $148.00 $10,360.00 SUB-TOTAL= $165,741 .00 WATER IMPROVEMENTS 1 Mobilization, Staking, All Required Testing by 1 LS $4,500.00 $4,500.00 Contractor & Trench Safety {Water Line) 2 8" PVC Water Line (C900, DR14) 2,116 LF $19.00 $40,204.00 3 6" PVC Water Line (C900, DR14) 151 LF $17.00 $2,567.00 4 4" PVC Water Line (C900, DR14) 404 LF $14.00 $5,656.00 5 Non-Structural Backfill Installation (All Water Line 2433 LF $3.00 $7,299.00 Sizes) 6 Structural Backfill Installation (All Water Line Sizes) 238 LF $12.00 $2,856.00 7 Tie into Existing Water Line 1 EA $750.00 $750.00 CD1-260-0552-E03.xlsx 2 of 5 ································· ··················--···········~------~---"=~---~···-------- Engineer's Cost Estimate 8 Standard Fire Hydrant Assembly 4 EA $3,500.00 $14,000.00 9 Standard Blow-off Assembly 2 EA $1 ,250.00 $2,500.00 10 12" (MJ) Gate Valve & Box 2 EA $1,500.00 $3,000.00 11 8" (MJ) Gate Valve & Box 7 EA $1,100.00 $7,700.00 12 6" (MJ) Gate Valve & Box 5 EA $800.00 $4,000.00 13 4" (MJ) Gate Valve & Box 1 EA $750.00 $750.00 14 12" x 8" (MJ) Tee 1 EA $975.00 $975.00 15 8" x 8" (MJ) Tee 1 EA $975.00 $975.00 16 8" x 6" (MJ) Tee 4 EA $850.00 $3,400.00 17 6" x 6" (MJ) Tee 1 EA $750.00 $750.00 18 8" x 6" (MJ) Reducer 1 EA $600.00 $600.00 19 6" x 4" (MJ) Reducer 1 EA $500.00 $500.00 20 8" (MJ) 22.5 deg Bend 2 EA $550.00 $1,100.00 21 8" (MJ) 11 .25 deg Bend 5 EA $450.00 $2,250.00 22 6" (MJ) 22.5 deg Bend 1 EA $350.00 $350.00 23 4" (MJ) 45 deg Bend 1 EA $300.00 $300.00 24 8" (MJ) Plug w/2" Tap 1 EA $350.00 $350.00 25 6" (MJ) Plug 1 EA $250.00 $250.00 26 4" (MJ) Plug w/2" Tap 1 EA $300.00 $300.00 27 Dual Water Service (Long Side) 8 EA $1,900.00 $15,200.00 28 Dual Water Service (Short Side) 16 EA $950.00 $15,200.00 29 Single Water Service (Long Side) 8 EA $1,400.00 $11,200.00 30 Single Water Service (Short Side) 7 EA $600.00 $4,200.00 SUB-TOTAL= $153,682.00 CD1-260-0552-E03.xlsx 3 of 5 Engineer's Cost Estimate SANITARY SEWER IMPROVEMENTS 1 Mobilization, Staking, Trench Safety & TV Inspection 1 LS $6,000.00 $6,000.00 (Sewer Line) 2 6" PVC Sanitary Sewer (SDR-26, D3034) 2,029 LF $25.00 $50,725.00 3 6" PVC Sanitary Sewer (SDR-26, 02241) 219 LF $29.00 $6,351 .00 4 Non-Structural Backfill Installation (All Sewer Line 1892 LF $3.00 $5,676.00 Sizes) 5 Structural Backfill Installation (All Sewer Line Sizes) 356 LF $14.00 $4,984.00 6 4' Diameter Standard Manhole w/32" Opening (Ring 6 EA $3,200.00 $19,200.00 & Cover) 7 4' Diameter Drop Manhole w/32" Opening (Ring & 2 EA $5,500.00 $11,000.00 Cover) 8 Cement Stabilized Sand Bedding 60 LF $23.00 $1,380.00 9 6" Sewer Line End Plug 1 EA $125.00 $125.00 10 Dual Sanitary Sewer Service (Long Side) 18 EA $1,750.00 $31,500.00 11 Dual Sanitary Sewer Service (Short Side) 11 EA $650.00 $7,150.00 12 Single Sanitary Sewer Service (Long Side) 3 EA $1,200.00 $3,600.00 13 Single Sanitary Sewer Service (Short Side) 1 EA $750.00 $750.00 SUB-TOTAL= $148,441.00 ESTIMATED CONSTRUCTION COST= $898,098.50 10% CONTINGENCY= $89,809.85 GRAND TOTAL= $987,908.35 CD1-260-0552-E03.xlsx 4 of 5 ----------------··"""""""""""""""""""'""""""'"""""""'"""""""""'""'"~ .. ~-----~=~==' , Engineer's Cost Estimate RME Consulting Engineers TEXAS FIRM REGISTRATION No. F-4695 POST OFFICE BOX 9253 COLLEGE STATION, TEXAS 77842 OFF/FAX: (979) 764-0704 E-mail: civil@m1engineer.com Estimates and projections prepared by RME Consulting Engineers relating to construction cosis and schedules, operation nnd maintenance costs, equipment characteristics and performance, and operating results are based on this office's experience, qualifications and judgment as a design professional. Since RME has no control over weather. cost and availability of labor, material and equipment, labor produ~'livity, construction contractor's procedures and methods, unavoidable delays, construction contra.ctor's methods of determining prices, economic conditions, competitive bidding or market conditions and other factors affecting such estimates or projecti011s, this office does not guarantee that actual rates, costs, performance, schedules, etc., will not vary from estimates and projections prepared by the Engineer of record. CD1-260-0552-E03.xlsx 5 of 5 ----------------------.... ~······"'""'""'"~'"·-·-············-,,,,····=-· ""·····=···-=--=····=·····=.:·--=·· ==-=···-================ Erika Bridges From: Erika Bridges Sent: To: Wednesday, Feb ruary 25, 2015 5:52 PM 'Rabon Metcalf' Cc: Alan Gibbs; 'Chris Rhodes' Subject: RE: Creek Meadows, S7Pl -College Station, TX: Channel Real ignment Rabon, We briefly discussed it in our staff meeting, and we rea lly don't have enough information at this time to say whether or not we would have any additional requirements. Sorry, that proba bly isn't the answer you were hoping for, but the information is just too limited at this point. As I mentioned previously, we are okay with the realignment in concept but will need further analysis. Thanks, Erika From: Rabon Metcalf [mailto:rabon@rmengineer.com] Sent: Wednesday, February 25, 2015 8:27 AM To: Erika Bridges Cc: Alan Gibbs; 'Chris Rhodes' Subject: RE : Creek Meadows, S7Pl -College Station, TX: Channel Realignment Erika: Following up on this matter per our phone co nversation Friday (2/20). Thanks, Rabon A. Metcalf, P.E., C.F.M. ~ h , ,r;E: r 3800 SH No. 6, Suite 108G < 77845> P.O. Box 9253 College Station, TX 77842 Off: (979) 764-0704 Fax: (979) 764-0704 The information transmitted, by RME Consulting Engineers (RME), for the above referenced project is considered by RME to be confidential. This material is intended ONLY for the use of the recipient named above and permission is not granted to the recipient for distribution of these documents in any form or fashion. The recipient understands and agrees to RME that upon release of these documents is no longer responsible for their use or modification. The user and recipient of the documents accept full responsibility and liability for any consequences arising out of the use of these documents. From: Rabon Metcalf [mailto:rabon@rmengineer.com] Sent: Friday, February 20, 2015 8:41 AM To: 'Erika Bridges' Cc: 'agibbs@cstx.gov'; 'Chris Rhodes' 1 Subject: RE: Creek Meadows, S7Pl -College Station, TX: Channel Realignment Importance: High Erika: I just wanted to double check that the city will be ok with the proposed cross-section (trying to match existing shape with some erosion control due to disturbed soils} before we move forward with USACE and limited flood study. It will not be worth the Developer's$$ if the channel realignment will require a pilot channel and/or concrete sideslope lining. Let me know and thanks. Rabon A. Metcalf, P.E., C.F.M. ' 3800 SH No. 6, Suite 108G <77845> P.O. Box 9253 College Station, TX 77842 Off: (979) 764-0704 Fax: (979) 764-0704 The information transmitted, by RME Consulting Engineers (RME), for the above referenced project is considered by RME to be confidential. This material is intended ONLY for the use of the recipient named above and permission is not granted to the recipient for distribution of these documents in any form or fashion. The recipient understands and agrees to RME that upon release of these documents is no longer responsible for their use or modification. The user and recipient of the documents accept full responsibility and liability for any consequences arising out of the use of these documents. From: Rabon Metcalf [mailto:rabon@rmengineer.com] Sent: Thursday, February 5, 2015 5:50 PM To: 'Erika Bridges' Cc: 'agibbs@cstx.gov'; 'Chris Rhodes' Subject: RE : Creek Meadows, S7Pl -College Station, TX: Channel Realignment Erika: Per our phone conversation, it is my understanding that the Scope below is generally what will be required to real ign approximately 150' of the existing creek. Also, as we discussed, I'm not looking for the CoCS to determine if this work can be covered by the NWP 29 (just letting you know that the creek realignment would necesate the PCN of the NWP 29). . Rabon A. Metcalf, P.E., C.F.M. r ' 3800 SH No. 6, Suite 108G <77845> P.O. Box 9253 College Station, TX 77842 Off: (979) 764-0704 Fax: (979) 764-0704 2 The information transmitted, by RME Consulting Engineers {RME), for the above referenced project is considered by RME to be confidential. This material is intended ONLY for the use of the recipient named above and permission is not granted to the recipient for distribution of these documents in any form or fashion. The recipient understands and agrees to RME that upon release of these documents is no longer responsible for their use or modification. The user and recipient of the documents accept full responsibility and liability for any consequences arising out of the use of these documents. From: Rabon Metcalf [mailto:rabon@rmengin eer.com] Sent: Tuesday, January 27, 2015 11:39 AM To: 'Erika Bridges' Cc: 'agibbs@cstx.gov'; 'Chris Rhodes' Subject: Creek Meadows, S7Pl -College Station, TX: Channel Realignment Erika: CMP is considering realigning the existing creek as shown (see attached PDF -bottom left corner). The creek is not in mapped floodplain and the proposed improvement I believe will be covered by NWP 29. Please let me know if the VERY preliminary design looks reasonably acceptable and the below Scope appears to be what the City will require. • H&H data included in the project Drainage Report; • VERY limited HEC-RAS model of the creek to verify flows, velocity, BFE of creek; • PCN required by NWP 29. Thanks, Rabon A. Metcalf, P.E., C.F.M. 3800 SH No. 6, Suite 108G < 77845> P.O. Box 9253 College Station, TX 77842 Off: (979) 764-0704 Fax: (979) 764-0704 The information transmitted, by RME Consulting Engineers (RME), for the above referenced project is considered by RME to be confidential. This material is intended ONLY for the use of the recipient named above and permission is not granted to the recipient for distribution of these documents in any form or fashion. The recipient understands and agrees to RME that upon release of these documents is no longer responsible for their use or modification. The user and recipient of the documents accept full responsibility and liability for any consequences arising out of the use of these documents. 3 --- -_. ---_. --.... ---~:::~ .. ::: -------~ ----:: __ _ CONSTRUCTION SITE NOTICE FOR THE Texas Commission on Environmental Quality (TCEQ) Storm Water Program TPDES GENERAL PERMIT TXR150000 The following information is posted in compliance with Part II.D.2. of the TCEQ General Permit Number TX.RI 50000 for discharges of storm water runoff from construction sites. Additional information regarding the TCEQ storm water permit program may be found on the internet at: http://www.tceq.state.tx.us/perrnitting/water quality/stormwater/TXRI 5 AIR.html -- Contact Name and Phone Number: Chris Rhodes (979) 260-2800 Project Description: Creek Meadows -Section 7, Phase Two Located southeast of Greens Prairie Trail and north of Royder Road. (Physical address or description of the site's Estimated Start Date: 5/1/15 location, estimated start date and projected end date, or date that disturbed soils will be Estimated End Date: 12/31/15 stabilized) Location of Storm Water Pollution RME Consulting Engineers P.O. Box 9253 Prevention Plan : College Station, TX 77842 For Construction Sites Authorized Under Part 11.D.2. (Obtaining Authorization to Discharge) the following certification must be completed: I Chris Rhodes (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.D.2. of TPDES General Permit TXRl 50000 and agree to comply with the terms of this permit. A storm water pollution prevention plan has been developed and implemented according to permit requirements. A copy of this signed notice is supplied to the operator of the MS4 if discharges enter an MS4 system. 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 v· olations. ~d:? r:h-+at-e~_.,.,~-.~~~~~~~~ c TCEQ Office Use Only Permit No.: RN: CN: Region: Notice of Intent (NOI) for Stormwater Discharges Associated with Construction Activity under TPDES General Permit (TXR150000) IMPORTANT: • Use the INSTRUCTIONS to fill out each question in this form. • Use the CHECKLIST to make certain all you filled out all required information. Incomplete applications WILL delay approval or result in automatic denial. • Once processed your permit can be viewed at: http: //www2. tceq. texas.gov /wq dpa/index.cfm ePERMITS: Sign up now for online NOI: https: //www3.tceq.texas.gov /steers/index.cfm Pay a $225 reduced application fee by using ePermits. APPLICATION FEE: • You must pay the $325 Application Fee to TCEQ for the paper application to be complete. • Payment and NOI must be mailed to separate addresses. • Did you know you can pay on line? • Go to https://www3.tceq.texas.gov/epay/index.cfm • Select Fee Type: GENERAL PERMIT CONSTRUCTION STORM WATER DISCHARGE NOI APPLICATION • Provide your payment information below, for verification of payment: [!]Mailed Check/Money Order No.:-------------- Name Printed on Check:--------------0 EPAY Voucher No.: _________________ _ Is the Payment Voucher copy attached? D Yes RENEW AL: Is this NOi a Renewal of an existing General Permit Authorization? (Note: A permit cannot be renewed after June 3, 2013.) 0Yes The Permit number is: TXR15, ______ _ (If a permit number is not provided, a new number will be assigned.) l!JNo 1) OPERATOR (.\pplicant) a) If the applicant is currently a customer with TCEQ, what is the Customer Number (CN) issued to this entity? You may search for your CN at: http: //www12. tceq. texas.gov I crpub /index.cfm ?fuseaction =cust.CustSearch TCEQ 20022 (03/05/2013) Page 1 b) What is the Legal N rune of the entity (applicant) applying for this permit? Oldham Goodwin Group, LLC (The legal nrune must be spelled exactly as filed with the Texas Secretary of State, County, or in the legal document forming the entity.) c) What is the nrune and title of the person signing the application? The person must be an executive official meeting signatory requirements in TAC 305-44(a). Prefix (Mr. Ms. Miss): _M_r_. __ First/Last Nrune: _C_h_n_·s_Rh __ od_e_s ______________ Suffix: ____ _ Title: VP -Construction Management Credential: ______ _ d) What is the Operator Contact's (Responsible Authority) contact information and mailing address as recognized by the US Postal Service (USPS)? You may verify the address at: http://zip4.usps.com/zip4/welcome.jsp Phone#: (979) 268-2000 ext: _____ Fax #: (979) 846-7020 E-mail: chris@oldhrungoodwin.com Mailing Address: 2800 South Texas Avenue, Ste. 401 Internal Routing (Mail Code, Etc.): ___________________ _ City: Bryan State:-=TXc:.::.... _____ ZIP Code:__,_7-'--7_80_2 _____ _ If outside USA: Territory: _____ Country Code: Postal Code: _____ _ e) Indicate the type of Customer (The instructions will help determine your customer type): D Individual [!]Limited Partnership D Sole Proprietorship-OBA D Joint Venture D General Partnership D Corporation D Trust D Estate D Federal Government D State Government D County Government D City Government D Other Government t) Independent Operator? [!]Yes D No (If governmental entity, subsidiary, or part of a larger corporation, check "No".) g) Number of Employees: [!]0-20; 021-100; 0101-250; 0251-500; or 0 501 or higher h) Customer Business Tax and Filing Numbers: (REQUIRED for Corporations and Limited Partnerships. Not Required for Individuals, Government, or Sole Proprietors) State Franchise Tax ID Number: -------------------Feder al Tax ID: ------------------------ Texas Secretary of State Charter (filing) Number:------------- DUNS Number (if known): ------------------- :!) APPLIC.-\TIOJ\" l'Ol'\'L\CT If TCEQ needs additional information regarding this application, who should be contacted? Is the application contact the same as the applicant identified above? D Yes, go to Section 3). [!] No, complete section below. Prefix (Mr. Ms. Miss): Mr. First/Last Nrune: _Ra_b_o_n_M_e_t_cal_f _________________ Suffix: __ _ Title: Owner Credential: PE, CFM TCEQ 20022 (03/05/2013) Page 2 Organization Name: RME Consulting Engineers Phone No.: (979) 764-0704 ext: ___ Fax Number: (979) 764-0704 E-mail: rabon@rmengineer.com Mailing Address:_P_O_B_o_x-'9'-2-"5'""3 _______________________ _ Internal Routing (Mail Code, Etc.)=---------------~------City: College Station State:_TX ______ ZIP Code:~77~8_4~2 _____ _ Mailing Information if outside USA: Territory: Country Code: ______ .Postal Code:. ________ _ 3) REGUL\TED E='JTITY (RE) I:\FOR:\L\TIOI\ 01'\ PRO.JECT OR SITE If the site of your business is part of a larger business site or if other businesses were located at this site before yours, a Regulated Entity Number (RN) may already be assigned for the larger site. Use the RN assigned for the larger site. Search TCEQ's Central Registry to see if the larger site may already be registered as a regulated site at: http://www12.tceq.texas.gov/ci:pub/index.cfm?fuseaction=regent.RNSearch. If the site is found, provide the assigned Regulated Entity Reference Number and provide the information for the site to be authorized through this application below. The site information for this authorization may vary from the larger site information. a) TCEQ issued RE Reference Number (RN): RN _____________ _ b) Name of project or site (the name known by the community where located): Creek Meadows -Section 7, Phase Two c) In your own words, briefly describe the primary business of the Regulated Entity: (Do not repeat the SIC and NAICS code): Urban residential subdivision development d) County (or counties if> 1) _B_r-'-a_zo_s _____________________ _ e) Latitude: 30°31'45.85"N Longitude: 96°1]'10.7o"W t) Does the site have a physical address? D Yes, complete Section A for a physical address. [!]No, complete Section B for site location information. Section A: Enter the physical address for the site. Verify the address with USPS. If the address is not recognized as a delivery address, provide the address as identified for overnight mail delivery, 911 emergency or other online map tools to confirm an address. Physical Address of Project or Site: Street Number: Street Name:----------------City: State: _____ ZIP Code: ___ _ TCEQ 20022 (03/05/2013) Page3 Section B: Enter the site location information. If no physical address (Street Number & Street Name), provide a written location access description to the site. (Ex.: located 2 miles west from intersection of Hwy 290 & IH35 accessible on H 2 o South On the southeast side of Greens Prairie Trail and approximately 2730 L.F. north of its intersection with Royder Road. City w ere t e site is ocate or, i College Station State: Texas ZIP Code where the site is located: 7,_,7c..::8'-'4""5'------- 4 ) GEt\ER.-\L CIL-\R.-\CTERISTICS a) Is the project/site located on Indian Country Lands? 0 Yes -If the answer is Yes, you must obtain authorization through EPA, Region 6. (!]No b) Is your construction activity associated with a facility that, when completed, would be associated with the exploration, development, or production of oil or gas or geothermal resources? 0 Yes -If the answer is Yes, you may be under jurisdiction of the Railroad Commission of Texas and may need to obtain authorization through EPA, Region 6. (!]No c) What is the Primary Standard Industrial Classification (SIC) Code that best describes the construction activity being conducted at the site? Primary SIC Code: _1s ..... 2_1 ____ _ d) If applicable, what is the Secondary SIC Code(s): ______________ _ e) What is the total number of acres disturbed?_!_,_ _______________ _ t) Is the project site part of a larger common plan of development or sale? 0 Yes -If the answer is Yes, the total number of acres disturbed can be less than 5 acres. (!]No -If the answer is No, the total number of acres disturbed must be 5 or more. If the total number of acres disturbed is less than 5 then the project site does not qualify for coverage through this Notice of Intent. Coverage will be denied. See the requirements in the general permit for small construction sites. g) What is the name of the first water body(s) to receive the stormwater runoff or potential runoff from the site? Peach Creek Tributary 16.4.3 h) What is the segment number(s) of the classified water body(s) that the discharge will eventually reach? 12 2 TCEQ 20022 (03/05/2013) Page4 i) Is the discharge into an MS4? [!] Yes -If the answer is Yes, provide the name of the MS4 operator below. 0No If Yes, provide the name of the MS4 operator: City of College Station Note: The general permit requires you to send a copy of the NOi to the MS4 operator. j) Are any of the surface water bodies receiving discharges from the construction site on the latest EPA-approved CW A 303( d) List of impaired waters? 0 Yes -If the answer is Yes, provide the name(s) of the impaired water body(s) below. (!]No If Yes, provide the name(s) of the impaired water body(s): k) Is the discharge or potential discharge within the Recharge Zone, Contributing Zone, or Contributing Zone within the Transition Zone of the Edwards Aquifer as defined in 30 TAC Chapter 213? D Yes -If the answer is Yes, complete certification below by checking "Yes." [!]No I certify that a copy of the TCEQ approved Plan required by the Edwards Aquifer Rule (30 TAC Chapter 213) is either included or referenced in the Stormwater Pollution Prevention Plan. D Yes TCEQ 20022 (03/05/2013) Pages 5) CERTIFICATION Check Yes to the certifications below. Failure to indicate Yes to ALL items may result in denial of coverage under the general permit. a) I certify that I have obtained a copy and understand the terms and conditions of the Construction General Permit (TXR..150000). [!]Yes b) I certify that the full legal name of the entity applying for this permit has been provided and is legally authorized to do business in Texas. [!]Yes c) I understand that a Notice of Termination (NOT) must be submitted when this authorization is no longer needed. [!]Yes d) I certify that a Stormwater Pollution 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 TXRl.50000. Note: For multiple operators who prepare a shared SWP3, the confirmation of an operator may be limited to its obligations under the SWP3 provided all obligations are confirmed by at least one operator. [!]Yes Operator Certification: I Chris.Rhodes >·~~~~~~~~~~~~~~~~~~~~~- Typed or printed name VP -Construction Management Title 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. I further certify that I am authorized under 30 Texas Administrative Code 305-44 to sign and submit this document, and can provide documentation in proof of such authorization upon request. Signature: -~-=----+4.,_...__fd~~ ~RA-~-~---Date:,t1>A- (Use blue ink) TCEQ 20022 (03/05/2013) Page6 NOTICE OF INTENT CHECKLIST (TXR130000) • Did you complete everything? Use this checklist to be sure! • Are you ready to mail your form to TCEQ? Go to the General Information Section of the Instructions for mailing addresses. This checklist is for use by the operator to ensure a complete application. Missing information may result in denial of coverage under the general permit. (See NOi process description in the Instructions) I Application Fee: If paying by Check: 0 Check was mailed separately to the TCEQs Cashier's Office. (See Instructions for Cashier's address and Application address.) 0 Check number and name on check is provided in this application. If using ePay: D The voucher number is rovided in this a lication or a co of the voucher is attached. PERMIT NUMBER: Permit number rovided -if this a lication is for renewal of an existin authorization. OPERATOR INFORMATION -Confirm each item is complete: D Customer Number (CN) issued by TCEQ Central Registry 0 Legal name as filed to do business in Texas (Call TX SOS 512/ 463-5555) 0 Name and title of responsible authority signing the application 0 Mailing address is complete & verifiable with USPS. www.usps.com 0 Phone numbers/ e-mail address 0 Type of operator (entity type) 0 Independent operator 0 Number of employees 0 For corporations or limited partnerships -Tax ID and SOS filing numbers "' A lication contact and address is com lete & verifiable with USPS. h : www.us s.com REGULATED ENTTIY (RE) INFORMATION ON PROJECT OR SITE -Confirm each item is complete: D Regulated Entity Reference Number (RN) (if site is already regulated by TCEQ) 0 Site/project name/regulated entity 0 Latitude and longitude http://www.tceq.texas.gov/gis/sqmaview.html 0 County 0 Site/project physical address. Do not use a rural route or post office box. "' Business descri tion GENERAL CHARACTERISTICS -Confirm each item is com lete: 0 Indian Country Lands -the facility is not on Indian Country Lands 0 Construction activity related to facility associated to oil, gas, or geothermal resources 0 Standard Industrial Classification (SIC) Code www.osha.gov/oshstats/sicser.html 0 Acres disturbed is provided and qualifies for coverage through a NOi 0 Common plan of development or sale 0 Receiving water body(s) 0 Segment number(s) 0 Impaired water body(s) 0 MS4 operator 0 Edwards Aquifer rule I CERTIFICATION 0 Certification statements have been checked indicating ''Yes" 0 Signature meets 30 Texas Administrative Code (TAC) 305.44 and is original. TCEQ-20022 Instructions ( 03/ 05/ 2013) Pagel