b'STORMWATERCATALOGTexas Commission on Environmental QualityPayment Submittal FormThe storm water application fee shall be sent under separate cover to the Texas Commission onEnvironmental Quality.This form must be used to submit your Storm Water Application Fee.Please complete the followinginformation, staple your check in the space provided at the bottom of this document, and mail it to:BY REGULAR U.S. MAIL BY OVERNIGHT/EXPRESS MAIL Texas Commission on Environmental Quality Texas Commission on Environmental QualityFinancial Administration Division Financial Administration DivisionCashiers Office, MC-214 Cashiers Office, MC-214ExampleP.O. Box 13088 12100 Park 35 CircleAustin, TX 78711-3088 Austin, TX 78753Fee Code: GPA Storm Water General Permit:TXR150000Check / Money Order No:Amount of Check/Money Order:Date of Check or Money Order:Name on Check or Money Order: Facility / Site Name: Facility / Site Physical Address: City:Zip Code:Staple Check In This SpaceTCEQ-20022 (05/03)Page 2 of 2310 INFO@PARKUSA.COM|888-611-7275|WWW.PARKUSA.COM'