Credit Card / Electronic Funds Transfer Payment Procedures: Credit card or electronic funds transfer payments for surface casing letters can only be made using the TCEQ ePay online application. Each request applies a $75.00 charge. Once the payment process is completed, please submit the following documents to the Surface Casing team at one of the addresses shown below: • • • • the completed Form TCEQ-0051P; a scaled map showing the well location and the surrounding survey lines location; a copy of the electric log if you are plugging or re-entering an existing well; and the payment voucher receipt printed at the completion of the ePay application process.
U.S. Mail Texas Commission on Environmental Quality Surface Casing, MC-151 P.O. Box 13087 Austin, TX 78711-3087 Overnight/Express Mail Texas Commission on Environmental Quality Surface Casing, MC-151 12100 Park 35 Circle Austin, TX 78753 TCEQ EPAY ONLINE INSTRUCTIONS: The TCEQ ePay online application is used by various programs at the agency. Following are instructions and screen images that will assist you in completing the application for a surface casing letter request. The website address for the TCEQ ePay online application is https://www.tceq.state.tx.us/epay .
TO MAKE IT EASIER WE HAVE HIGHLIGHTED THE FIELDS YOU MUST COMPLETE.
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Begin by entering your name and e-mail address in the required fields and then select “OK”
Your Name: E-Mail: Confirm E-Mail: OK
On the page below, proceed to Option 3: View List of Fees by Media. Select “WATER”
Option 1: Pay Invoice Amount
If you are paying an invoice you received from the TCEQ, enter the account number printed on the coupon portion of the bill.
Account:
OK
Option 2: Pay by Steers Reference Number
To pay by STEERS reference number, select the program area and enter the reference number to continue.
STEERS Program: STEERS Reference Number:
Storm Water (SW)
▼
OK
Option 3: View List of Fees by Media
If you are submitting a payment for a permit, self reporting fee, or other fee without an invoice, please select a media to view a list of fees. AIR WASTE WATER OTHER VIEW ALL
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Under “Surface Casing”, select “SURFACE CASING EXPEDITED LETTER”
Select Fee
Select a Different Media: AIR WASTE WATER OTHER VIEW ALL Please select a fee to pay. If you are paying for a fee for which you have a billing statement or a STEERS Reference number, press Cancel and use Option 1 or 2 to continue
WATER
Boat Sewage Disposal
Certification BOAT BOAT SEWAGE DISPOSAL DEVICE CERTIFICATION – BOAT PUMPHOUSE BOAT SEWAGE DISPOSAL DEVICE CERTIFICATION – PUMPHOUSE
Surface Casing
Other SURFACE CASING EXPEDITED LETTER
On the following page, complete the “Site Information”, “Customer Information” and “Billing Information” boxes: Site Information Box: For the “Site Name” field, please input the county name, lease name and well number (e.g. Smith Co. ABC #1). “Site Address” is not required for this type of request. In the “Site Location” field, please input the fax number for the recipient of the surface casing letter. Customer Information Box: the customer is the owner of the well. Please input the requested information. Note that the last 4 digits of zip code are not required. Billing Information Box: Please input the requested information for the credit card holder. Note that the last 4 digits of zip code are not required.
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Items marked with an * are required. Enter the fee information below, then press OK to add to your shopping cart or Cancel to return to the Home page.
Fee Information
Fee: Fee Amount:* SURFACE CASING EXPEDITED LETTER $75.00
The information below is necessary to ensure your electronic payment is processed appropriately and credited to the correct entity.
Site Information
Site Name:* Site Address: City, State, ZIP Site Location:*
TX
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County name lease name well number
-
(Fax number) XXX-XXX-XXXX
Customer Information
Customer Name:* Customer Address:* City, State, ZIP* State Franchise Tax ID:
Well Owner’s name Well Owner’s address TX
▼
-
Billing Information
Billing Name:* Billing Address:* City, State, ZIP*
TX
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Credit Card Holder
-
Other Information
Program Area: Program Area ID: Program Number: Optional Comments:
OK Cancel
SURFACECASE
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After filling out the required data and selecting “OK”, you will have the option to select another transaction or prepare to pay. Each surface casing letter request requires a separate transaction. If you have additional transactions, select “Select More Fees”. If you have finalized your transaction, select “Check Out”.
Shopping Cart
There are 1 items in your shopping cart. If you wish to remove an item, check the remove box then click update shopping cart. Note: The shopping cart is limited to 20 items CC = Credit Card ACH = Electronic Funds Transfer Fee Description Remove AR Number Amount Payment SURFACE CASING EXPEDITED LETTER Total fees for transaction:
Select More Fees
$75.00 $75.00
Update Shopping Cart
ACH/CC
□
Check Out
On the following page, you will complete the “Payor Information” and the “Credit Card” boxes Payor Information Box: Please input the requested information for the credit card holder. If the card is a personal account, enter the name on the account again in the “Company Name” blank. Address data should be the billing address of card holder (PO Box is acceptable). For phone number, use dashes not parentheses. ACH (Electronic Funds Transfer) Box: Please input the requested information. Credit Card Box: Select Master Card or Visa for “Card Type”. In the field for “Card Number”, do not use dashes or spaces.
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Payor Information (*All fields Required)
Name on Account: Company Name: Street Address: City, State, ZIP Phone Number:
XXX-XXX-XXXX TX
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Credit Card Account Holder
(If individual, enter payor name)
-
(Number on file with Credit Card Co.)
ACH (Electronic Funds Transfer)
Account Type:
▼
Bank Routing Number: Account Number:
Credit Card
Card Type: Select Card Type xxxxxxxxxxxxxxxx 01
▼ ▼
Card Number: Expiration Date:
2008
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OK
Cancel
After filling out the required data and selecting “OK”, the following “Transaction Information” page appears. If everything is correct, click on the “box” next to the confirmation statement, and then select the “Confirm” box.
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Transaction Information
Date: Payment Method: Amount: ePay User: Actor Email: IP:
01/02/2008 MAST credit card $75.00 J. SMITH sc@tceq.state.tx.us J. SMITH
Payor Information
Payor Name: Company: Adresss:
J. SMITH XYZ OIL CO 1000 Main St Austin, TX, 78701
Phone:
111-111-1111
Cart Items
Fee Description AR Number SURFACE CASING EXPEDITED LETTER Total fees for transaction: Amount $75.00 $75.00
By clicking this box I am affirmatively demonstrating that I have reviewed the information above, wish to pay for the listed fees electronically, and am authorized to do so by the payment method indicated. Note: This transaction may take several minutes. Please do not press the Confirm button more than once. Multiple clicks could potentially cause you to be charged more than once.
Confirm Cancel
□
The following page is your receipt for the transaction. To access the TCEQ ePay Voucher Receipt, click on the highlighted voucher number under “Cart Items”. Print this voucher and submit a copy to the Surface Casing team with your application for a Surface Casing letter.
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Your transaction is complete. Note: It may take up to 3 working days for this electronic payment to be processed and be reflected in the TCEQ ePay system. Print this receipt and the vouchers for your records. An email receipt has also been sent.
Transaction Information
Trace Number: Date: Payment Method: Amount: ePay User: Actor Email: IP:
582EA000012345 01/02/2008 04:06 PM CC – Authorization 0000067899 $75.00 J. SMITH js@xyzoil.com 70.183.80.119
Payor Information
Payor Name: Company: Adresss:
J. SMITH XYZ OIL CO 1000 Main St Austin, TX, 78701
Phone:
111-111-1111
Cart Items
Voucher 14235 Fee Description SURFACE CASING EPEDITED LETTER Total fees for transaction:
ePay Again Exit ePay
AR Number
Amount $75.00 $75.00
Note: It may take up to 3 working days for this electronic payment to be processed and be reflected in the TCEQ ePay system. Print this receipt for your records
As stated, you will receive an e-mail confirmation of the transaction. If there is a problem with printing the TCEQ ePay Voucher Receipt while you are in the TCEQ ePay online application, you can follow the instructions at the bottom of the e-mail confirmation to access your transaction in the TCEQ ePay system. If you have any questions, please contact the Surface Casing team at 512-239-0515 or sc@tceq.state.tx.us
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