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Planning Division
245 East Bonita Ave., San Dimas CA 91773
(909) 394-6250
ENVIRONMENTAL
INFORMATION FORM
Part I - Initial Study
(To Be Completed B
y Applicant)
The purpose of this form is to inform the City of the basic components of the proposed
pr
oject so that the City may review the project pursuant to City policies, ordinances, and
guidelines; the California Environmental Quality Act (CEQA). The more thoroughly this
form is completed by the applicant, the more quickly the development proposal may be
considered. Attach all referenced special studies.
GENERAL INFORMATION:
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. Please note that it is the responsibility of the applicant to ensure that
the application is complete and legible at the time of submittal. Type or print using black ink only.
Application Number for the project to which this form pertains:
Project Title:
Name & Address of project owner(s):
Name & Address of developer or project sponsor:
Contact Person & Address:
Name & Address of person preparing this form (if different from above):
Telephone
Number:
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PROJECT INFORMATION & DESCRIPTION: Attach additional sheets if necessary.
1)
Provide a full scale (8-1/2x 11) copy of the USGS Quadrant Sheet(s) which includes the project site, and indicate the
site boundaries.
2)
Provide a set of color photographs which show representative views into the site from the north, south, east and west;
views into and from the site from the primary access points which serve the site; and representative views of significant
features from the site. Include a map showing location of each photograph.
3)
Project Location (describe):
4)
Assessors Parcel Number(s):
5)
Gross Site Area (ac/sq. ft.):
6)
Net Site Area (total site size minus area of public streets & proposed dedications):
7)
Describe any proposed General Plan Amendment or Zone Change which would affect the project site:
8)
Include a description of all permits which will be necessary from the City of San Dimas and other governmental agencies
in order to fully implement the project:
9)
Describe any noise sources and their levels that now affect the site (aircraft, roadway noise, etc.) and how they will affect
proposed uses:
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10)
Describe the proposed project in detail. This should provide an adequate description of the site in terms of ultimate use
which will result from the proposed project, proposed square footage, and number of floors of construction. Indicate if
there are proposed phases for development, the extent of development to occur with each phase, and the anticipated
completion of each increment. Attach additional sheets if necessary:
11)
Will the proposed project change the pattern, scale or character of the surrounding general area of the project?
12)
Indicate the type of short-term and long-term noise to be generated, including source and amount. How will these noise
levels affect adjacent properties and on-site uses? What methods of sound proofing are proposed?
13)
Indicate proposed removals and/or replacements of mature or scenic trees:
14)
Indicate any bodies of water (including domestic water supplies) into which the site drains:
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15)
Indicate expected amount of water usage (See Attachment A for usage estimates). For further clarification, please
contact Golden State Water Company at 121 Exchange Place, San Dimas, CA 91773, 909-599-1289.
a. Residential (gal/day) ____________________ Peak use (gal/day) ____________________
b. Commercial/Industrial (gal/day/ac) __________________ Peak use (gal/min/ac) __________________
16)
Indicate proposed method of sewage disposal (check one): _______ Septic Tank ______ Sewer. If septic tanks are
proposed, attach percolation tests. If discharge to a sanitary sewage system is proposed, indicate expected daily
sewage generation (See Attachment A for usage estimates). For further clarification, please contact the San Dimas
Public Works Department at 909-394-6240.
a. Residential (gal/day) ____________________________________________________________________________
b. Commercial/Industrial (gal/day/ac)
_____________________________________________________________________
RESIDENTIAL PROJECTS:
17)
Number of residential units:
Detached Units (indicate range of parcel sizes, minimum lot size and maximum lot size:
Attached Units (indicate whether units are rental or for sale units):
18)
Anticipated range of sale prices and/or rents:
Sale Price(s) $_____________________ to $_______________________
Rent(s) (per month) $_____________________ to $_______________________
19)
Specify floor plan area (square feet, excluding garage) and number of bedrooms by unit type:
20)
Indicate anticipated household size by unit type:
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21)
Indicate the expected number of school children who will be residing within the project. Contact the appropriate School
District (see Attachment B).
a. Elementary: _________________________________
b. Junior High: _________________________________
c. Senior High _________________________________
COMMERCIAL, INDUSTRIAL AND INSTITUTIONAL PROJECTS:
22)
Describe type of use(s) and major function(s) of commercial, industrial or institutional use:
23)
Total floor area of commercial, industrial, or institutional use by type:
24)
Indicate hours of operation:
25)
Number of employees:
Total:
Maximum
Shift:
Time of
Maximum
Shift:
26)
Estimation of the number of workers to be hired that currently reside in the City:
27)
For commercial and industrial uses only, indicate the source, type and amount of air pollution emissions. (Data should
be verified through the South Coast Air Quality Management District, at (909) 396-2000):
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ALL PROJECTS:
28)
Have the water, sewer, fire, and flood control agencies serving the project been contacted to determine their ability to
provide adequate service to the proposed project? If so, please indicate their response.
29)
In the known history of this property, has there been any use, storage, or discharge of hazardous and/or toxic materials?
Examples of hazardous and/or toxic materials include, but are not limited to, PCBs; radioactive substances; pesticides
and herbicides; fuels, oils, solvents, and other flammable liquids and gases. Also note underground storage of any of the
above. Please list the materials and describe their use, storage, and/or discharge on the property, as well as the dates of
use, if known.
30)
Will the proposed project involve the temporary or long-term use, storage or discharge of hazardous and/or toxic
materials, including but not limited to those examples listed above? If yes, provide an inventory of all such materials to
be used and proposed method of disposal. The location of such uses, along with the storage and shipment areas, shall
be shown and labeled on the application plans.
ENVIRONMENTAL SETTING:
31)
Describe the physical setting of the site as it exists before the project including information on topography, soil stability,
plants and animals, mature trees, trails and roads, drainage courses and scenic aspects. Describe any existing
structures on site (including age and condition) and the use of the structures. Attach photographs of significant features
described. In addition, cite all sources of information (i.e., geological and/or hydrologic studies, biotic and archeological
surveys, traffic studies):
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32)
Describe the surrounding properties, including information on plants and animals and any cultural, historical, or scenic
aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land use (one-family, apartment houses,
shops, department stores, etc.) and scale of development (height, frontage, setback, rear yard, etc.):
33)
Describe the known cultural and/or historical aspects of the site. Cite all sources of information (books, published
reports, archaeological surveys, oral history, etc.):
APPLICANT CERTIFICATION:
I hereby certify that the statements furnished above, and in the attached exhibits, present the data and information required for
adequate evaluation of this project to the best of my ability; and that the facts, statements, and information presented are true and
correct to the best of my knowledge and belief. I further understand that additional information may be required to be submitted before
an adequate evaluation can be made by the City of San Dimas.
Date: ___________________ Signature: ______________________________________________
Print Name: ______________________________________________
Title: ______________________________________________
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ATTACHMENT AWATER & SEWER SERVICE DEMAND
Water UsageAverage use per day
Residential
Single Family 600 gal/day
Apartment/Condominium/Townhome 400 gal/day
Commercial/Industrial
General and Regional Commercial 3000 gal/day/ac
Neighborhood Commercial 1500 gal/day/ac
General Industrial 1500 gal/day/ac
Industrial Park 3000 gal/day/ac
Peak Usage
For all uses: Average use x 2.0
Sewer Flows
Residential
Single Family 270 gal/day
Apt/Condos 200 gal/day
Commercial/Industrial
General Commercial 2000 gal/day/ac
Neighborhood Commercial 100-1500 gal/day/ac
General Industrial 2000 gal/day/ac
Heavy Industrial 3000 gal/day/ac
ATTACHMENT B SCHOOL DISTRICTS
Bonita Unified School District (east of Cataract, south of Base Line Rd., east of Valley Center, north of Puente St.)
115 W. Allen Avenue
San Dimas, CA 91773
(909) 971-8320
Glendora Unified School District (north of Base Line Rd., west of Cataract Avenue)
500 N. Loraine Avenue
Glendora, CA 91723
(626) 963-1611
Charter Oak Unified School District (west of Valley Center)
20240 Cienega Avenue
Covina, CA 91723
(626) 966-8331
Covina-Valley Unified School District (south of Puente Street and Walnut Creek)
519 E. Badillo Street
Covina, CA 91723
(626) 974-7000