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DIR-2008-28b CITY OF CUPERTINO 10300 Torre Avenue, Cupertino, California 95014 (408) 777-3308 To: Mayor and City Council Members Chairperson and Planning Commissioners From: Steve Piasecki, Director of Community Developm~ Prepared by: Colin Jung, Senior Planner Date: September 18, 2008 Subject: Director's Minor Modification, DIR-2008-28 to erect a state-mandated, above- ground, phase II vapor recovery system for an underground storage tank at an existing gasoline station located at 20755 Stevens Creek Blvd. Chapter 19.132 of the Cupertino Municipal Code allows for administrative approval of minor changes in a project. The Director reports his decision to the City Council and Planning Commission in time to allow an appeal of the decision within fourteen calendar days. DISCUSSION: The applicant, Michelle Doyle of Stantec Consulting, representing ConocoPhillips, is required by the California Air Resources Board (CARB) to install vapor recovery systems to filter gasoline vapors that emanate when refueling vehicle fuel tanks (Exhibit A). Presently, CARB has certified only one system that complies with its current air quality regulations, the Healy System, Inc. Phase II Enhanced Vapor Recovery System (Exhibit B). Its appearance, height (about 8.5 feet tall), and above-ground installation are governed by the CARB's rulemaking and are not subject to City regulation. This is a statewide mandate and eventually all gasoline stations in California will be retrofitted with this system. Staff has been working with the applicant to minimize the visual impact of this vapor recovery system to the extent possible. The system will be located behind and against the existing sales building and screened from direct street views by an ll-foot tall galvanized sheet metal enclosure painted to match the sales building. New, exposed piping and the vent risers will be screened by the back wall of the building. ACTION: The Director of Community Development deems the modification minor and approves the change as described in the plan set exhibit entitled: "Profit Center #2705721/ 20755 Stevens Creek Blvd.jCupertino, CA/Enhanced Vapor Recovery Upgrade" dated 5/30/08, and consisting of three sheets labeled EVR1, EVR2 and HT1, and with the following conditions of approval: DIR-2008-28 Page 2 September 18, 2008 1. The Healy System enclosure and associated visible piping shall be painted the same color as the building. 2. The connecting piping shall not extend above the roof line of the building. 3. Provide new 24" box screening trees on the east and south side oUhe enclosure if not already present. The approval is effective September 18, 2008. The fourteen calendar day appeal period expires on October 2, 2008. Enclosures: Exhibit A: CARB Vapor Recovery Certification Procedure, CP-201 Exhibit B: CARB Executive Order VR-201-A: Healy Systems, Inc. Phase II EVR System Plan Set G: Planning/ PDREPORTS / DIRreports /2008/ DIR-2008-28.doc J<,!g~~~')'~I:~'t;.:.,~::/.: ;, t'i'"'~''''''-'':'q~l}-~O ~ ~J'.;':-:',_;'::':'.~-"-'" ...:.....-.___ <:\....."11'.....: ,. i 'd__ --'" ... ..... ". ,"," ,. ,',c:- .' CIR v....... .Le.. l ,-. !-..- ,...., .,.: " : !.ii. , ,II . o _!) ',~...: .';. " .-'., ... . t~t.; b'} f--; A. California Environmental Protection Agency Air Resources Board Vapor Recovery Certification Procedure CP-201 Certification Procedure for Vapor Recovery Systems at Gasoline Dispensing Facilities A set of definitions common to all Certification and Test Procedures are in: 0-200 Definitions for Vapor Recovery Procedures For the purpose of this procedure, the term "CARB" refers to the California Air Resources Board, and the term "Executive Officer" refers to the CARB Executive Officer, or his or her authorized representative or designate. 1. GENERAL INFORMATION AND APPLICABILITY This document describes the procedure for evaluating and certifying Phase I and Phase II vapor recovery systems, and components, used at Gasoline Dispensing Facilities (GDF), A CARB Executive Order certifying the system shall be issued only after all of the applicable certification requirements have been successfully completed. This Certification Procedure, CP-201, is adopted pursuant to Section 41954 of the California Health and Safety Code (CH&SC) and is applicable to vapor recovery systems installed at gasoline dispensing facilities for controlling gasoline vapors emitted during the fueling of storage tanks (Phase I) and the refueling of vehicle fuel tanks (Phase II). Vapor recovery systems are complete systems and shall include all associated dispensers, piping, nozzles, couplers, processing units, underground tanks and any other equipment or components necessary for the control of gasoline vapors during Phase I or Phase II refueling operations at GDF. 1.1 Legislative and Regulatory Requirements of Other State Agencies As required pursuant to Sections 41955 and 41957 of the CH&SC, the Executive Officer shall coordinate this certification procedure with: 1.1.1 Department of Food and Agriculture, Division of Measurement Standards (DMS) 1.1.2 Department of Forestry and Fire Protection, Office of the State Fire Marshall (SFM) 1.1.3 Department of Industrial Relations, Division of Occupational Safety and Health (DOSH) California Air Resources Board October 8, 2003 CP-201, Page 1 DIf2 '~co~'-d~ ~q< '""'.\".';<u....~r"{'~ ~~.~ f.':..~)<:.i~, .(."L l)".~t. r;""'~ 11 "') t.<< ..~.. .:a-'~' "'- D;>.1-';:: ....___..1-::L. -~ ("1f'1' 1 ,,-,'1,"':'.:- ' if ,-' j <.:.i, . ,..., I.' h '-.' ___ . ...----. -"-. ~"..". -~--:--. ." . . . - "'.. . ,'. . ~ ....... k,t\ ;.....,/.,..' ,':'il:'- 1.1_"f."';;'" v" ... ,--' Prior to certification of the vapor recovery system by the Executive Officer, the applicant shall submit plans and specifications for the system to each of these agencies. Certification testing by these agencies may be conducted concurrently with CARB certification testing; however, the approval of the SFM, OMS and DOSH shall be a precondition to certification by CARB. The applicant is responsible for providing documentation of these approvals to CARB. 1.2 Requirement to Comply with All Other Applicable Codes and Regulations Certification of a system by the Executive Officer does not exempt the system from compliance wiUlolner applica5le codes ana regulations sucR .as state fire coBes, weights and measures regulations, and safety codes and regulations. 2. GENERAL PERFORMANCE STANDARDS AND SPECIFICATIONS 2.1 Performance Standards A performance standard defines the minimum performance requirements for certification of any system, including associated components. Ongoing compliance with all applicable performance standards shall be demonstrated throughout certification testing. Systems and components shall comply, throughout the warranty period, with the applicable performance standards. 2.2 Performance Specifications A performance specification is an engineering requirement that relates to the proper operation of a specific system or component thereof. Performance specifications shall be identified in the application for certification. Ongoing compliance with the minimum level of performance specifications identified herein shall be demonstrated throughout certification testing and specified in the certification Executive Orders. Any applicant may request certification to a performance specification that is more stringent than the minimum performance standard or specification. The performance specification to which a system or component is certified shall be the minimum allowable level of performance the component is required to meet throughout the warranty period. Typical performance specifications include, but are not limited to, pressure drop and pressure integrity. 2.3 Innovative System The innovative system concept provides flexibility in the design of vapor recovery systems. A vapor recovery system that fails to comply with an identified performance standard or specification may qualify for consideration as an innovative system, provided that the system meets the primary emission factor/efficiency, complies with all other applicable requirements of certification, and the Executive Officer determines that the emission benefits of the innovation are greater than the consequences of failing to meet the identified standard or specification. California Air Resources Board October 8, 2003 CP-201, Page 2 D ll2-~()oB -;-2 ~t " .:: r ':,'" 0" ."I}"':,~'! ,.... -'...... ,~,<,J ",,' " _ .-",.. "L"",~~,,"~.Ji"a"'/i ~.. . .,' ,.,.,. 1'-1 0 ~;I::~~ I~:~:' :~:;-::;~-:-..-=-- '. . ~~~:.p. .;.),;';:'o'JI'\1 dll.-. ....-......._-...... .---, .... C"l"'. ~..'" Actlt- ''''''I'I'd'V ,.' '\'" V- \ ~Ul'!~::!.'_:'\\ I, ,...,/ ..' ,- Fi- \'\~~ \ t.: B , $t8t8 of Callforn ia AfRHESOURCES BOARD EXECUTIVE ORDER VR-201-A Healy Systems, Inc. Phase II Enhanced Vapor Recovery (EVR) System Not Including ISO WHEREAS, the California Air ResourcesBoard (ARB) has established, pursuant to 'California Health and Safety Code sections 25290.1.2, 39600, 39601 and 41954,tertification procedures for systems designed for the control of gasoline vapor emissions during motor vehicle fueling operations (Phase II EVR vapor recovery systems) in its CP-201, Certification Procedure for Vapor Recovery Systems at Gasoline Dispensing Facilities (Certification Procedure) as last amended July 22,2004, incorporated by reference in title 17, California Code of Regulations, section 94011; WHEREAS, ARB has established, pursuant to California Health and Safety Code sections 39600, 39601, 39607, and 41954, test procedures for determining the compliance of Phase II vapor recovery systems with emission standards; WHEREAS, Healy Systems, Inc. (Healy) requested certification of the Healy Systems, Inc. Phase 1\ Enhanced Vapor Recovery (EVR) System (Healy Phase II EVR System Not Including In-Station Diagnostics (ISO)); WHEREAS, the Certification Procedure provides that the ARB Executive Officer shail issue an Executive Order if he or she determines that the vapor recovery system conforms to all of the applicable requirements set forth in the Certification Procedure; WHEREAS, I, Catherine Witherspoon, California Air Resources Board Executive Officer, find that the Healy Phase II EVR System Not lncluding ISO conforms With all requirements set forth ill the Certification Procedure, including compatibility 'vvhen fueling vehicles equipped with onboard refueling vapor recovery systems, and results in a vapor recovery system which is at least 95.0 percent efficient and shall not exceed 0.38 pounds of hydrocarbons per 1,000 gallon of gasoline transferred when tested pursuant to TP-201.2, Efficiency and Emission Factor for Phase {/ Systems (October 8,2003); NOW, THEREFORE, IT IS HEREBY ORDERED that the Healy Phase II EVR System Not lnc1uding ISO is certified to be at least 95 percent efficient and does not exceed 0.38 pounds of hydrocarbon per 1,000 gallons of gasoline transferred in attended and/or self-service mode when used with an ARB-certified Phase I D ,e-~oe-.;2'O DIRECTCB'ft APPROVf':l.L DATE: "__ 1-10:;.e_~.*, SIGNf.\fUHE: . C~ . . -- It~ COr;1MUNIT DE .DIR. -2- vapor recovery system and installed, operated , and maint.amed as specified herein and in the following exhibits. . Exhibit 1 contains a list of the equipment certffiedfor . use with the Healy Phase II EVR System N()tlhcluding ISO. Exhibit 2contaihs the pertormance standards, specifications, typical installation dra\ivin:gs aDd . maintenariceintervals applicable to the Healy Phase Ii EVR SystemNot lnc!uding ISD as installed in a gasoHnedispensing facility {GDF). Exhibit 3 contains the manufacturing specifications. Exhibit 4 is the test procedure for verifying pertormance oHheHealy Clean Air Separator. Exhibit 5is the vapor to liquid ratio f8StpfricedurB.lQr~-erif1.dng performance of the Healy 900 Nozzle. Exhibit 6 is the HeaiyPhasell EVR System Limited Warranty. Exhibit 7 is the nozzle bag test prGcedure, Exhibit Bis items to consider in conducting TP-201.3. IT 1S FURTHERORDERED that compliance with the applicable certification requirernents, rules and regulations of the Division of Measurement Standards of the Department of Food and Agriculture, the Office of the State Fire Marshal of the Department of Forestry and Fire Protection, the Division of Occupational Safety and Health of the Department of Industrial Relations, and the Division of Water Quallty of the state Water Resources Control Board is made a condition ofthis certification. IT IS FURTHER ORDERED that Healy shail provide a warranty for the vapor recovery system and components to the initial purchaser and each subsequent purchaser within the warranty period. The manufacturer of components listed in Exhibtt1 not manufactured by Healy Systems, Inc. shall provide a warranty to each of their components certified herein. The warranty shall include the ongoing compliance with a1l applicable performance standards and specifications and shall comply with all warranty requirements in Section 9.2 ofthe Certification Procedure. Healy or other manufacturers may specify that the warranty is contingent upon the use of trained installers. Copies of the warranty for the system and components shall be made available to the gasoline dispensing facility owner/operator. IT IS FURTHER ORDERED that the certified components manufactured by Healy Systems, Inc. shall be 100% performance tested by the manufacturer using the applicable procedures listed in Exhibit 3. IT IS FURTHER ORDERED that the certified Healy Phase II EVR System Not Including ISO shall be installed, operated, and maintained in accordance with the ARB Approved Installation, Operation, and Maintenance Manual for the Healy Phase II EVR System Not Including ISO. A copy of this Executive Order and the ARB Approved fnstaflation, Operation and Maintenance Manual for the Healy Phase II EVR System Not Including ISD shali be maintained at each GDF where a certified Healy Phase ]1 EVR System Not Including ISO is installed. HE\L Y PHASE II EVR SYSTEM - VR-201-A D'f?-~o~ ~~f.. D!R~r-'~.''"\~'''$'v.'' ):'riOl:'il1\IA' ; " lol ~n:o .J ~ \1; w ~ ~,,', ~.\ J it ~.l t.... Vi :.... [V-..r:.. /),_Jq~ ~. -' \I L. '_'" ___~L.L.. ,-' (""-. ~ ('':', ~-j ;), "T' ~ t.} :: ~ . \.:)J ....110:1.." l.J, II.:;. ...__.... . _ -- --~...,-- ~ C:()\".p.f'1 Jt'-.1\'! '\I' .r:\l.r:O........ 'IR. '0' ." '., ..",-.. . 'M 'C'- -"3- .' ,', ',",. - - ". IT IS FURTHER ORDERED that equiprnent listed in Exhibit 1, Unless exempted in writing by ARB, shall be clearly identified by permanent identification number showing the manufacturer's name and model number. IT .is FURTHER ORDERED that any alteration in the equipment parts, design, installation, or operation of the system certified hereby is prohibited and deemed inconsistent with this certification, unless the alteration has been submitted in writing and approved in writing by the Executive Officer or Executive Officer Gelegat~ IT\~S FURTHER ORDERED tllat the following requirements are made a condition of certification. The owner or operator of the Healy Phase II EVR System Not Including ISO shall conduct and pass the following tests no later than 60 days after startup and at least once in each tvvelve month period, using the following test procedures: TP-2D1.3, Determination of 2 Inch WC Static Pressure Performance of Vapor Recovery Systems of Dispensing Facilities (March 17, 1999); Exhibit 4. Determination of static Pressure Performance of the Healy Clean Air Separator; and Exhibit 5, Vapor to Liquid Volume Ratio for Healy Phase Jl EVR System. Shorter time periods may be specifled in accordance with local district requirements. Notification of testing, and submittal of test results, shall be done in accordance WITh local district requirements and pursuant to policies established by that district. Alternative test procedures, including most recent versions of the test procedures listed above, may be used if determined by the ARB Executive Officer or Executive Officer delegate, in wrrting, to yield equivalent results. IT 1S FURTHER ORDERED that the following requirements are made a condition of certification. The owner or operator of the Healy Phase II EVR System Not Including ISO shall conduct, and pass, the following tests no later than 60 days after startup using Exhibit 7, Nozzle Bag Test Procedure, TP-201.4, Dynamic Back Pressure (July 3, 2002), shall be conducted in accordance with the conditions listed in item 1 of the Vapor Recovery Piping Configurations section of Exhibit 2. Local districts have the authority to require conducting of Exhibit 5, Vapor to Liquid Volume Ratio for Healy Phase 1I EVR System, In lieu of TP-201.4, Dynamic Back Pressure (July 3,2002), provided that at least 2 gallons of product are introduced into the system through each dispenser riser prior to conducting the test. Notification of testing and submittal of test results shall be done in accordance wrth local district requirements and pursuant to the policies established by that district. Alternatrve test procedures, including most recent versions of the test procedures listed above, may be used if determined by the ARB Executive Officer or Executive Officer delegate, in writing, to yield equivalent results. IT is FURTHER ORDERED that, except as provided above, local districts at their opilon will specify the testing frequency of the nozzle vapor valves. If nozzle vapor HEALY PHASE II EVR SYSTEM - VR-201-A DI12 -~~..~~. "~,' r.,~~~"'rOR'.$ A..?Pf (...1',}:I"\1.. v,rl>.. . '1-t~L-O \:~/:'~~ ~;:. '"::-;i,:-~:':"- -=-. ::. ~:.; ~ \:A ; ~ r... ~ j~' l"i ~. . ...:~:-;~~~"'~.~. t "\-;" l t "r'-i' .l-d\ ,: '.;;.,,~.".: I I . '/D - v .; " . .iDtR. A -;-- .. . . valve tests are required by the district, the testshall be conducted in accordance with Exhibit 7, Nozzle Bag Test Procedure. iT IS FURTHER ORDERED that the Healy Phase II EVR System Not Including ISO shall be compatible with fuels ill common use in California at the time of certification and any modifications to comply with future California fuel requirements shall be approved in writing by the Executive Officer or Executive Officer delegate. IT IS FURTHER ORDERED that the certification of the Healy Phase II EVR System Not Including ISO is valid through August 1 r 2009. Executed at Sacramento, California, this B~ day of April 2005. c~ ~eL-) .~ Catherine Witherspoon {/ Executive Officer Attachments: Exhibit 1 Equipment List Exhibit 2 System Specifications Exhibit 3 Healy Manufacturing Performance Standards and Specifications Exhibit 4 Determination of Static Pressure Performance of the Healy Clean Air Separator Vapor to Liquid Volume Ratio for Healy Phase 11 EVR System Healy Phase 1\ EVR System Limited Warranty Nozzle Bag Test Procedure Items to Consider in Conducting TP-201.3 Exhibit 5 Exhibit 6 Exhibit 7 t:xhibit 8 HEALY PHASE II EVR SYSTEM - VR-201-A F:\Pf"oIKt\A-B-C-D\CONPHl\2008268093\DWGS\3Yerrnlt\2008258093 E~1.dwg D1mKale:120 LTScale:D.7 Plot:[TIme:Aug22.2ClO8-01;0B9m lo9ln:cmort........] Pre-pIol:[JAN oe. 2001 15:Jll-CAM) Xr.fc-x78.chnjI-x2OO82SSOOJ.dq 1m00000-wnop.bmp-.GetMop..P9- ~~ '\ ~ ~ :<\ o ~I ~ n; Z CIJ o :::D m m A CD o c r m ~ :::D o e); VI 0 n ,. !;; 0 '" 0 . 0 '" 0 '" 0 i~----~----~l I I f' a [DJ (;J I ~ ----tJ~J--~..J 1IiU . ~~~ ~~/i ~ ~ / r ~ - i !iO 9' :-' ~ ,... ~ (,j N..... ~~ ~~~~~'ll~~ g~~;~~~~i ~ ~~~ ~~~~i~~~ ~~U~ I c=~~~~i~~~~~~~~~~~~~~ ~I~ I~!ci!;~~~~~ !;~~~~~~~~~~~~it~~~~~~ ~~ ~ ~zz;~!ilI2 i"l" G~ ~n/i~ ~z "~"',lI a 6~0I J!;J z ~}5~ ~~-ln ~~CII cj$lgn I 1IIIIII:I;6;28!:! 0 ~~ ~;;~ ?;;~I~ i~; ~~~~i ~~~~~~~~~~~~l'~ p~~; m ~~/ii~:~rlll~56:~~~ ~~~~~;~$;;~jiiii:~~IlI~!i~~ e~ ~ i~~ III ~ ~~~CF~cCR~~~~~ ie III ~~~~I~~~~~ ~~ ~i~~~R~~~R~~I~~~~~~~~~ ~ ~r~lilil~ilI~f;l~ ~g l'!"l r:;c~~i"'ii/!~g ~iia!r~~!::~ g ~~~~~g~!~~ ~a ~~ ~~~~i~~~~g~~8~~~~~~ a ;i~!~~~:;:a~ ~ ~~ g~~~il~"~~~~~;~~ ~~ ~ ~!i~;~~i!~ ~g ii ~~~~~~g ~~~~!~~~ ~~ g ~ia~~~ ~~a III ~2 iilli~~%~ oi~~i~z. ~~ .6~~~~~:~i e~ ~2 i;~ ~~~ 5oiio~~: ~!:: ~ ~ ~~~'" ~S!iiI~ ~" III ~ c P ~~~ ~l:Oo~ ~y;.. z~ z i~~~!:~!~~ ~! ~i :~I ~~~ ~Iii~i~~ ~! j ~ ~~~ii~~~ ~~ i~ ~/!~ . ~ :iggi/ii~ ~c "l ~ is! >la~i!" 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POST 1.S. 2JC2.16 G^. t rii < ~~ ~ nl ~~ Z () r- I 0 (j) C ~ ----, t ~ r- ~~ r- ~~ -U ~ S; 5;? Z ~~ I ~~ 'N Olj ~= ~~ ;z:~ ffi~ 1.S. 2JC2x 16 GA. 1.S. 2JC2.16 GA. T.S. 2x2.16 GA. 1.5. 2.2xl1 GA. POST I I h >!~ ~~ ~~ ril < :<72 -U -4 . )> (j)Z - 7" Om mz (j)() (U r- ::l 0 c:L(j) CPc f;~ 7"nl ~~ :=~ (5 z 1.S. 2JC2x 11 GA. POST 1.5. 2.2.11 GA. POST ~~ "U~ ~~ (J)OO ...... >> ~... (i) --I :0 Z rn m"t;7 ~.. C)- ~ -<<'\) CO, ~ :D :1JC\ _ n1 ...~ · . \ (1)0 o SJ~ Q , eo \ ~~ :a~ :g;: Ori"t C <""~ ))I .... ...~ ~~ ~~ r o o }- ::l o z County of Santa Clara COLT Office of the County Clerk -Recorder Business Division _� County Government Center TA C�r'� -70 West Hedding Street, E. Wing, 1" Floor San Jose, California 95110 (408)299-5665 CEQA DOCUMENT DECLARATION ENVIRONMENTAL FILING FEE RECEIPT Santa Clara County Clerk- Recorder's Office State of California REGINA ALCOMENORAS, County Clerk -Recorder by Veronica Aguirre, Deputy Clerk- Recorder, PLEASE COMPLETE THE FOLLOWING: 1. LEAD AGENCY: City of Cupertino 2. PROJECT TITLE: DIR-2008-28 3. APPLICANT NAME: Michelle Doyle (Stantec) PHONE: 408.777.3308 4. APPLICANT ADDRESS: 20755 Stevens Creek Boulevard 5. PROJECT APPLICANT IS A: ❑ Local Public Agency ❑ School District ❑ Other Special District ❑ State Agency M Private Entity 6. NOTICE TO BE POSTED FOR 30 ' . DAYS. 7. CLASSIFICATION OF ENVIRONMENTAL DOCUMENT a. PROJECT THAT IS SUBJECT TO DFG FEES ❑ 1. ENVIRONMENTAL IMPACT REPORT (PUBLIC RESOURCES CODE §21152) $ 2,606.75 $ 0.00 ❑ 2. NEGATIVE DECLARATION (PUBLIC RESOURCES CODE §21080(C) $ 1,876.75 $ 0.00 ❑ 3. APPLICATION FEE WATER DIVERSION (STATE WATER RESOURCES CONTROL BOARD ONLY) $ 886.25 $ 0.00 ❑ 4. PROJECTS SUBJECT TO CERTIFIED REGULATORY PROGRAMS $ 886.25 $ 0.00 ,❑ 5. COUNTY ADMINISTRATIVE FEE (REQUIRED FOR as=1 THROUGH a=4 ABOVE) $ 50.00 $ 0.00 Fish & Game Code §711.4(e) b. PROJECT THAT IS EXEMPT FROM DFG FEES © 1. NOTICE OF EXEMPTION ($50.00 COUNTY ADMINISTRATIVE FEE REQUIRED) $ 50.00 $ 50.00 ❑ 2. A COMPLETED "CEQA FILING FEE NO EFFECT DETERMINATION FORM" FROM THE DEPARTMENT OF FISH ✓i< GAME, DOCUMENTING THE DFG'S DETERMINATION THAT THE PROJECT WILL HAVE NO EFFECT ON FISH, WILDLIFE AND HABITAT, OR AN OFFICIAL, DATED RECEIPT I PROOF OF PAYMENT SHOWING PREVIOUS PAYMENT OF THE DFG FILING FEE FOR THE *SAME PROJECT IS ATTACHED ($50.00 COUNTY ADMINISTRATIVE FEE REQUIRED) DOCUMENT TYPE: ❑ ENVIRONMENTAL IMPACT REPORT ❑ NEGATIVE DECLARATION $ 50.00 $ 0.00 c. FILING THAT IS NOT SUBJECT TO DFG OR COUNTY ADMINISTRATIVE FEES • ❑ NOTICE OF PREPARATION 8. OTHER: FEE (IF APPLICABLE): $ 9. TOTAL RECEIVED................................................................................................;........................................ $ 50.00 *NOTE: "SAME PROJECT" MEANS NO CHANGES. IF THE DOCUMENT SUBMITTED IS NOT THE SAME (OTHER THAN DATES), A "NO EFFECT DETERMINATION" LETTER FROM THE DEPARTMENT OF FISH AND GAME FOR THE SUBSEQUENT FILING OR THE APPROPRIATE FEES ARE REQUIRED. THIS FORM MUST BE COMPLETED AND ATTACHED TO THE FRONT OF ALL CEQA DOCUMENTS LISTED ABOVE (INCLUDING COPIES) SUBMITTED FOR FILING. WE WILL NEED AN ORIGINAL (WET SIGNATURE) AND TWO COPIES. INCLUDEA THIRD COPY IF YOU REQUIRE AN ENDORSED COPY FOR YOUR RECORDS. CHECKS FOR ALL FEES SHOULD BE MADE PAYABLE TO: SANTA CLARA COUNTY CLERK -RECORDER PLEASE NOTE: FEES ARE ANNUALLY ADJUSTED (Fish & Game Code §711.4(b); PLEASE CHECK WITH THIS OFFICE AND THE DEPARTMENT OF FISH AND GAME FOR THE LATEST FEE INFORMATION. NO PROJECT SHALL BE OPERATIVE, VESTED, OR FINAL, NOR SHALL LOCAL GOVERNMENT PERMITS FOR THE PROJECT BE VALID, UNTIL THE FILING FEES REQUIRED PURSUANT TO THIS SECTION ARE PAID." 'Fish & Game Code §711.4(c)(3) 09-09-2008 Document No.: 15174 Number of Pages: 2 Filed and Posted On: 10/30/2008 AL 91r076AE Through: 11/29/2008 CRO Order Number: 146741 Fee Total: 50.00 REGINA ALCOMENORAS, County Clerk -Recorder by Veronica Aguirre, Deputy Clerk- Recorder, PLEASE COMPLETE THE FOLLOWING: 1. LEAD AGENCY: City of Cupertino 2. PROJECT TITLE: DIR-2008-28 3. APPLICANT NAME: Michelle Doyle (Stantec) PHONE: 408.777.3308 4. APPLICANT ADDRESS: 20755 Stevens Creek Boulevard 5. PROJECT APPLICANT IS A: ❑ Local Public Agency ❑ School District ❑ Other Special District ❑ State Agency M Private Entity 6. NOTICE TO BE POSTED FOR 30 ' . DAYS. 7. CLASSIFICATION OF ENVIRONMENTAL DOCUMENT a. PROJECT THAT IS SUBJECT TO DFG FEES ❑ 1. ENVIRONMENTAL IMPACT REPORT (PUBLIC RESOURCES CODE §21152) $ 2,606.75 $ 0.00 ❑ 2. NEGATIVE DECLARATION (PUBLIC RESOURCES CODE §21080(C) $ 1,876.75 $ 0.00 ❑ 3. APPLICATION FEE WATER DIVERSION (STATE WATER RESOURCES CONTROL BOARD ONLY) $ 886.25 $ 0.00 ❑ 4. PROJECTS SUBJECT TO CERTIFIED REGULATORY PROGRAMS $ 886.25 $ 0.00 ,❑ 5. COUNTY ADMINISTRATIVE FEE (REQUIRED FOR as=1 THROUGH a=4 ABOVE) $ 50.00 $ 0.00 Fish & Game Code §711.4(e) b. PROJECT THAT IS EXEMPT FROM DFG FEES © 1. NOTICE OF EXEMPTION ($50.00 COUNTY ADMINISTRATIVE FEE REQUIRED) $ 50.00 $ 50.00 ❑ 2. A COMPLETED "CEQA FILING FEE NO EFFECT DETERMINATION FORM" FROM THE DEPARTMENT OF FISH ✓i< GAME, DOCUMENTING THE DFG'S DETERMINATION THAT THE PROJECT WILL HAVE NO EFFECT ON FISH, WILDLIFE AND HABITAT, OR AN OFFICIAL, DATED RECEIPT I PROOF OF PAYMENT SHOWING PREVIOUS PAYMENT OF THE DFG FILING FEE FOR THE *SAME PROJECT IS ATTACHED ($50.00 COUNTY ADMINISTRATIVE FEE REQUIRED) DOCUMENT TYPE: ❑ ENVIRONMENTAL IMPACT REPORT ❑ NEGATIVE DECLARATION $ 50.00 $ 0.00 c. FILING THAT IS NOT SUBJECT TO DFG OR COUNTY ADMINISTRATIVE FEES • ❑ NOTICE OF PREPARATION 8. OTHER: FEE (IF APPLICABLE): $ 9. TOTAL RECEIVED................................................................................................;........................................ $ 50.00 *NOTE: "SAME PROJECT" MEANS NO CHANGES. IF THE DOCUMENT SUBMITTED IS NOT THE SAME (OTHER THAN DATES), A "NO EFFECT DETERMINATION" LETTER FROM THE DEPARTMENT OF FISH AND GAME FOR THE SUBSEQUENT FILING OR THE APPROPRIATE FEES ARE REQUIRED. THIS FORM MUST BE COMPLETED AND ATTACHED TO THE FRONT OF ALL CEQA DOCUMENTS LISTED ABOVE (INCLUDING COPIES) SUBMITTED FOR FILING. WE WILL NEED AN ORIGINAL (WET SIGNATURE) AND TWO COPIES. INCLUDEA THIRD COPY IF YOU REQUIRE AN ENDORSED COPY FOR YOUR RECORDS. CHECKS FOR ALL FEES SHOULD BE MADE PAYABLE TO: SANTA CLARA COUNTY CLERK -RECORDER PLEASE NOTE: FEES ARE ANNUALLY ADJUSTED (Fish & Game Code §711.4(b); PLEASE CHECK WITH THIS OFFICE AND THE DEPARTMENT OF FISH AND GAME FOR THE LATEST FEE INFORMATION. NO PROJECT SHALL BE OPERATIVE, VESTED, OR FINAL, NOR SHALL LOCAL GOVERNMENT PERMITS FOR THE PROJECT BE VALID, UNTIL THE FILING FEES REQUIRED PURSUANT TO THIS SECTION ARE PAID." 'Fish & Game Code §711.4(c)(3) 09-09-2008 I Filek 15174 10/30/2008 �4 City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 Notice of Exemption To: County Clerk -Recorder . 70, W. Hedding Street,lst Floor East Wing—Business Division San Jose, CA 95110 Project Title: DIR-2008-28 Project. Location - (be specific): 20755 Stevens Creek Boulevard Project Location'- (City): Cupertino Project Location - (County): Santa Clara Description of Project: Director's Minor Modification for an air cleaner tank for gasoline at an existing service station. Name of Public Agency approving project: Name of Person or Agency carrying out project: Michelle Doyle (Stantec) Exempt Status: (check one) — Ministerial (Sec. 21080(b)(1); 15268); —Declared Emergency (Sec. 21080(b)(3); 15269(a)); —Emergency Project (Sec. 21080(b)(4); 15269(b)(c)); x Categorical Exemption.. State type and section number: 15301– Existing Facilites _Statutory Exemption. State code number: Reasons why project is exempt: Project involves the erection of mechanical equipment to meet California Air Resources Board regulations. Lead Agency Contact Person Colin Jung R Signature: r r Area code/telephone number (408) 777-3257 Date: October 16, 2008 Title: Senior Planner G: I Planning)ERCIExempt12008exemptl dir200828. doc