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Vote%01 <br />CITY OF SANTA ANA <br />FOOD SERVTCE ESTABLTSHMENT (FSE) <br />WASTEWATER DISCHARGE NOTICE <br />AND REGULAR PERMIT <br />FSE ID Effective Date: May 21 , 2018 <br />FSE Owner Name <br />FSE Name <br />FSE Address <br />FSE City, State, Zip <br />ICI DEVELOPI\4ENT <br />CENTRE ON SEVENTEENTH <br />2260 E 1z'n sr <br />SANTA ANA, CA 92705 <br />FSE Owner/Rep Email FSE Owner/Rep Phone: 714-580-7696 <br />A grease interceptor lS required at this FSE <br />Effective December 15, 2004, the Clty of Santa Ana adopted Ordinance Number NS 26-70 amending Chapter <br />39 of the Santa Ana Municipal Code adding fats, oils and grease (FOG) control regulations applicable to Food <br />Service Establishments (FSES). The ordinance requires all new and remodeled FSES to install and maintain <br />grease interceptors. FSEs without grease interceptors and that meet certain criteria are hereby issued a <br />conditional waiver under the terms of this Notlce and Conditional Waiver. <br />FSEs will be routinely inspected to evaluate the effectiveness of their grease control measures. Existing FSES <br />that discharge FOG and are out of compliance with the Ordinance provisions will be required to install grease <br />interceptors. All FSES must implement Kitchen Best Management Practices (BMPS) to remove FOG from the <br />waste stream entering the sewer system. <br />Program Rules and Regulations <br />The City has established Rules and Regulations for the FOG Program. Refer to the City website at <br />http.//rttltt.santa anq-qrg/Iu a/fo,t/docunrcnts/lirg rules and rcgulations. pd I' or contact the FOG <br />Control Program Manager at (714) 647 -3320 for copies of the Rules and Regulations. Also refer to these <br />sources for the Fats, Oils, and Grease Control Regulations (Section 39-56 of the City's Municipal Code) and <br />for copies of forms and educational material. <br />Notice and Regular Permit Notice <br />The City may amend this Notice and/or Regular Permit at any time. Compliance with the requirements <br />contained in this Notice and Regular Permit does not relieve the FSE of its obligation to comply with the Fats, <br />Oils, and Grease Control Regulations, any applicable pretreatment regulations, standards or requirements <br />under local, State, and Federal laws, includlng any such regulations, standards, requirements or laws that <br />may become effective during the term of this Notice and Regular Permit. Non-compliance with any term or <br />condition of this Notice and Regular Permit constitutes a violation of the Fats, Oils and Grease Conkol <br />Regulation and may result in revocation of the Permit. <br />Print Name (FSE Owner/Representative) | Sign Name (FSE Owner/Representative) I <br />BY signing, FSE owner agrees to all terms and conditions of this Notice and Condational Waiver. <br />Taig Higgins, P. E. <br />Principal Civil Engineer <br />Page I ol- I <br />Date <br />X