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SU0015055
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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SU0015055
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Entry Properties
Last modified
12/18/2023 10:12:52 AM
Creation date
7/22/2022 9:25:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0015055
PE
2632
FACILITY_NAME
PA-2200136
STREET_NUMBER
12887
Direction
E
STREET_NAME
BLOSSOM
STREET_TYPE
CT
City
LOCKEFORD
Zip
95237-
APN
05131049, -50
ENTERED_DATE
7/21/2022 12:00:00 AM
SITE_LOCATION
12887 E BLOSSOM CT
RECEIVED_DATE
11/3/2023 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
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EHD - Public
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® No,please provide,justification why not selected:Not financially feasible for this expansion development, <br /> PeriodN. Review <br /> You may request a five(5)day period to review a draft of the District's analysis of your project before it is finalized. However,if you <br /> choose this option, it will delay the project's finalization by five(5)business days, <br /> [C I request to review a draft of the District's analysis. <br /> • Deferral Schedule <br /> If the project's on-site air pollution reductions(mitigation measure)insufficiently reduced air pollution as outlined in Rule 9510,an <br /> off-site fee is assessed based on the excess air pollution. The money collected from this fee will be used by the District to reduce air <br /> pollution emissions 'off=site' on behalf of the project. <br /> An Applicant may request a deferral of all or part of the `off-site'fees up to,but not to exceed,the start date of construction. The start <br /> of construction is any of the following,whichever occcurs first:stark of grading,start of demolition,or any other site development <br /> activities not mentioned above. <br /> ❑ 1 request a Fee Deferral Schedule,and have enclosed the Fee Deferral Schedule Application. <br /> The Fee Deferral Schedule Application,can be found on the District's website at www.vallevair.org/ISR. <br /> P. Change of Project Developer <br /> The Applicant assumes all responsibility for ISR compliance for this project. If the project developer changes,the Applicant must <br /> notify the Buyer,and both Buyer and Applicant must file a`Change of Project Developer' form with the District. If there is a change <br /> of project developer,and a`Change of Project Developer' form is not filed with the District,the Applicant will remain liable for ISR <br /> compliance. <br /> The Change of Project Developer form can be found cn the District's website at www.valleyair.!2 SR. <br /> Q. Attachments <br /> Required. If applieable: <br /> ®Tract Map or Project Design Map ®Letter from Applicant granting Agent authorization <br /> ® Vicinity Map ❑Fee Deferral Schedule Application <br /> Application Filing Fee ❑Monitoring&Reporting Schedule <br /> $$41.00 for mixed use 1 non-residential/transporation 1 transit projects <br /> ® Supporting documentation for selected Mitigation <br /> DR <br /> $552.40 for residential projects only Measures <br /> R. Certification Statement <br /> I certify that I have reviewed and completed the entire application and hereby attest that the information relayed within is true and <br /> correct to the best of my knowledge. I commit to implementation of those on-site mitigation measures that 1 have selected above. [ <br /> am responsible for notifying the District if I will be unable to implement these mitigation measures_ If a committed mitigation <br /> measure is not implemented,the project may be re-assessed for air quality impacts. <br /> (An authorized Agent may sign the farm in lieu of the Applicant if an authorization letter signed by the Applicant is provided). <br /> Flame(printed): Ryan Ranchhod Title: Agent <br /> Signature: VM\ Date:9/1/2023 <br /> Central Region Office: 1990 E.Gettysburg Ave.Fresno,CA 93726-0244 TEL(559)230-6000 www.vallevair.or_gIISR <br /> Page 4 of 13 Revised August 30, 2022 <br />
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