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Notice of Exemption F I L E D Form D
To: NOV 0 8 2022 From: (Public Agency) City of San Clemente Engineering Division, 910 Calle Negocio, Suite 100
OftANGE COUNTY CLER,!S;lj,� DEPARTMENT
County Clerk BY: � DEPUTY
San Clemente, CA. 92673; Attn: Belgin Cuhadaroglu
(Address)
County of _o_
ra_
ng"-e _________ _
12 Civic Center Plaza, P.O. Box 238
Santa Ana, CA 92701
Project Ti
l
l
e: Montalvo and Riviera Pedestrian Bridges Coating Replacement Project.
Project Location - Specific:
The Montalvo bridge spans 96'-8' and Riviera Bridge spans 30', and both bridges are prefabricated steel with timber decking. The Bridges located at 200-ft west of the intersection of Ave Montalvo and Ave Lobeiro, and are in close proximity and parallel to OCTA Metrolink railroad. rrojoct Location -City: San ---------- Clemoote
Description of Nature, Purpose and Beneficiaries of Project:
Project Location - County: Orange
Currently the both bridges coating has become visibly deteriorated and is showing signs of rust, corrosion, and pitting.
Maintenance will include a complete removal and repair of the existing coating system. Coaling system will include applying a rust inhibitor, primer, and paint.
Nnmc of Puhlic: Aecncy Apprnving Pmject: City of San Clemente POSl=-E-0 Name of Person or Agency Carrying Out P
roject:
Exempt Status: (check one)
0 Ministerial (Sec. 21080(b)(I); 15268);
Ctty of San Clemente
0 Declared Emer&ency (Sec. 21080(b)(3); 15269(a)):
0 Emergency Project (Soc. 21080(b)(4): 15269(b)(c));
NOVO 8 2022
DfPARTMEN7
IKJ Categorical Bxemption. State type and section number: _S_e_c _tio_n_1_5_3 _01....:
,_C_la_s_s _1 ___________ _
0 S1atut0ry Exemptions. State code number: ____ ________________ _ Reasons why project is exe.mpt:
Consistent with Section 15301, Class 1, the project consists of general maintenance of components of the existing steel Montalvo and Riviera bridges.
Lead Agency
Contact Person: ----''---------- Kiel Koger Area CodefTelephone/Extension: {949) 361-6187 If filed by applicant:
I. Attach certified document of exemption finding.
2. Has a Notice of Exemption been filed by the public agency approving the project'/ I&:] Yes 0No Signature:
28 � ,?-""� Date: 11/03/2022 Title: Public Works Director Recorded in Official Records, Orange county
: ::::::: :: �:�
i:�ncy Date received for filing at
OP� llf 1
1 1
il�r i1li1
1mn�rni1
1�rn ii11� 11111111111 1
1 * $ R O O 1 4 0 5 2 6 6 3 $ * 1 NO FEE
202285000983 1 : 12 pm 11 /08/22
383 Vltlndx Z01
0.00 50.00 0.00 0.00 0.00 0.00 0.00 0.00
ATTACHMENT 5
State of California - Department of Fish and Wildlife
2022 ENVIRONMENTAL DOCUMENT FILING FEE
CASH RECEIPT
' DFW 7_53.5a (REV. 01101/22) Previously DFG 753.5a
SEE INSTRUCTIONS ON REVERSE. TYPE OR PRINT CLEARLY.
LEAD AGENCY LEADAGENCY EMAIL
CITY OF SAN CLEMENTE
COUNTY/STATE AGENCY OF FILING
!Orange ITI
PROJECT TITLE
Print , _ 1 Save I
RECEIPT NUMBER:
30- 1110812022 -0972
STATE CLEARINGHOUSE NUMBER (II appticat,le)
DATE
11/08/2022
DOCUMENT NUMBER
202285000983
MONTALVO AND RIVIERA PEDESTRIAN BRIDGES COATING REPLACEMENT PROJECT
PROJECT APPLICANT NAME
CITY OF SAN CLEMENTE
PROJECT APPLICANT ADDRESS
910 CALLE NEGOCIO STE 100
PROJECT APPLICANT {Check appropriote box)
0 local Public Agency O School Dislrtcl
CHECK APPLICABLE FEES:
D Environmental Impact Report (EIR)
D Mitigate<l/Negative Declaration (MND)(ND)
PRO.ECT APPLICANT EMA L
CITY STATE
SAN CLEMENTE CA
PHONE NUMBER
(949)361-6187
ZIP CODE
92673
0 Other Special District 0 S1ate Agency 0 Pnvate Entity $ ----------0.00
$ _______ __;o:.c.o=o
O COl1ified Regulatory Program (CRP) document - p.,ymenl due directly to CDFW $3,539.25
$2,548.00
$1,203.25 $ --------�o�.o=o
0 Exempt trom fee
E'.I Nolice of Exemplioo (attach)
D CDFW No Effect Dolennination (attach)
0 Fee previously paid (a1tach previously Issued cash receipt ccpy) D Water Right Application or Petition Fee (State Water Resources Cootrol Board ontyJ 0 County documentary handling fee
$850.00 $
$
0 Other $
PAYMENT METHOD:
D Cash O Credi!
SIGNATURE
X
OIUGIHAl • PROJECl APPLtCANT
0 Chec:l< 0 Other
COPY· COFW/ASO
TOT AL RECEIVED S
AGENCY OF FILING PRINTED NAME AND TITLE
DEPUTY CLERK, CLAUDIA FRANCO
COPY ·lEAOAOENCY COPY-COVNfYCLERK
0.00 0.00
0.00 OFVI 7$.J,!lii (Rrdl10t2022)