OF
30-11/24/2025 - 0907
202585001141.
FILED
CALIFORATE November 24, 2025
HUGH NGUYEN
ORANGE COUNTY CLERK - RECORDER
CLERK-RECORDER
CEQA FILING COVER SHEET Depury clerk
Complete and attach this form to each CEQA Notice filed with the County Clerk-Recorder
TYPE OR PRINT CLEARLY
Project Title
WELL 10 PFAS WATER TREATMENT PROJECT (CIP 53023)
Check Document being Filed:
Environmental Impact Report (EIR)
Mitigated Negative Declaration (MND) or Negative Declaration (ND) Notice of Exemption (NOE)
Other (Please fill in type):
FILED IN THE OFFICE OF THE ORANGE
COUNTY CLERK-REGORDER ON 11/24/2025
Posted 11/24/2025 Removed
Returned to agency on
DEPUTY 461
ling fees are due at the time a Notice of Determination/Exemption is flled with our office. For more informatio 1 tiling fees and No Effect Determinations, please refer to California Code of Regulations, Title 14, section 753.
Notice of Exemption
DALTORAND
To: Office of Planning and Research From: City of Fullerton 1400 Tenth Street, Room 121 303 West Commonwealth Avenue Sacramento, CA 95814 Fullerton, CA 92832
County Clerk FILED
County of Orange
PO Box 238
Santa Ana, CA 92701 NOV 2 4 2025
Project Title: Well 10 PFAS Water Treatment Project (CIP 53023) HUGH NGUYEN, CLERK-RECORDER Project Location - Specific: 1901 East Rosslynn Avenue, Fullerton CA, 92831 BY:_ DEPUTY Project Location - City: Fullerton Project Location - County: Orange Description of Nature, Purpose, and Beneficiaries of Project:
The project consists of the installation of approximately 3,300 feet of 12-inch water pipeline to connect Well 10 to the PFAS treatment facility at the Kimberly 2 Well for the treatment of per- and polyfluoroalkyl substances (PFAS) contaminants. The Kimberly 2 Well site consists of treatment vessels appurtenances to treat well discharge for both the Kim 2 Well and Well 10. The proposed Project would occur within areas that were previously disturbed by well and pipeline installations at the site and city street. The City of Fullerton is the beneficiary of this project and is the lead agency, Orange County Water District is the responsible agency. Project also include limited scope rehabbing the existing Well 10.
Beneficiary: General public
Name of Public Agency Approving Project: City of Fullerton Name of Person or Agency Carrying Out Project: City of Fullerton 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));
/ Categorical Exemption; Type and section number: Water main extension, 15303 • Statutory Exemptions; Code number: _
Reasons why project is exempt:
Construction and operations of water pipeline at a previously disturbed site representing the construction of limited footage of water pipeline to connect the existing facilities.
Lead Agency Contact Person: Todd P. Le Telephone Number: (714) 738-6563 Principal Water Engineer
If filed by applicant:
1. Attach certified document of exemption finding.
2. Has a Notice of Exemption been filed by the public agency approving the project? • Yes Of No sionature: TRadP. Le Date: 1/24/25
Title: Principal Water Engineer
• Signed by Lead Agency Date received for filing at OPR:
• Signed by Applicant
turala State of California - Department of Fish and Wildlife 2025 ENVIRONMENTAL DOCUMENT FILING FEE
CASH RECEIPT
DFW 753.5a (REV. 01/01/25) Previously DFG 753.5a
-Print Save
RECEIPT NUMBER:
30-11/24/2025-0907
STATE CLEARINGHOUSE NUMBER (If applicable)
SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY.
LEAD AGENCY LEAD AGENCY EMAIL DATE
CITY OF FULLERTON 11/24/2025
COUNTY/STATE AGENCY OF FILING ¡DOCUMENT NUMBER
ORANGE COUNTY 202585001141
PROJECT TITLE
WELL 10 PFAS WATER TREATMENT PROJECT (CIP 53023)
PROJECT APPLICANT NAME [PROJECT APPLICANT EMAIL PHONE NUMBER CITY OF FULLERTON (714) 738-6563
PROJECT APPLICANT ADDRESS CITY STATE ZIP CODE
303 WEST COMMONWEALTH AVENUE FULLERTON CA 92832
PROJECT APPLICANT (Check appropriate box)
X Local Public Agency • School District • Other Special District • State Agency • Private Entity CHECK APPLICABLE FEES:
• Environmental Impact Report (EIR) $ 4,123.50 $
• Mitigated/Negative Declaration (MND)(ND) $ 2,968.75 $ • Certified Regulatory Program (CRP) document - payment due directly to CDFW $ 1,401.75 $ * Exempt from fee
* Notice of Exemption (attach)
• CDFW No Effect Determination (attach)
• Fee previously paid (attach previously issued cash receipt copy) • Water Right Application or Petition Fee (State Water Resources Control Board only) 850.00$ • County documentary handling fee 50.00$
$
PAYMENT METHOD:
• Credit • Other TOTAL RECEIVED $ 0.00
SIGNATURE JAGENCY OF FILING PRINTED NAME AND TITLE
X Sarah Luna Deputy Clerk
ORIGINAL - PROJECT APPLICANT COPY - COFWIASB COPY - LEAD AGENCY COPY. COUNTY CLERK DFW 753.5a (Rev. 01012025)