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OregOlApartment of Environmental Qualita
LAND m'E COMPATIBILITY STATEMEN~
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WHAT IS A LAND USE COMPATIBILTY STATEMENT (LUeS)? A LUCS is a form
developed by DEQ to determine whether a DEQ permit or approval will be consistent with.
local government comprehensive plans and land use regulations.
State of Oregon
Department of
Environmental
Quality
WHY IS A LUeS REQUIRED? DEQ and other state agencies with permitting or approval
activities that affect land use are required by Oregon law to be consistent with local
comprehensive plans and have a process for determining consistency. DEQ activities affecting
land use and the requirement for a LUCS may be found in Oregon Administrative Rules (OAR)
Chapter 340, Division 18.
WHEN IS A LUeS REQUIRED? A LUCS is required for nearly all DEQ permits and certain
approvals of plans or related activities that affect land use prior to issuance of a DEQ permit or approval.
These permits and activities are listed in section I.D on p. 2 of this form. A single LUCS can be used if
more than one DEQ permit or approval is being applied for concurrently.
Permit modifications or renewals also require a LUCS when any of the following applies:
I. Physical expansion on the property or proposed use of additional land;
2. Alterations, expansions, improvements or changes in method or type of disposal at a solid waste
disposal site as described in OAR 340-093-0070(4)(b);
3. A significant increase in discharges to water;
4. A relocation of an outfall outside of the source property; or
5. Any physical change or change of operation of an air pollutant source that results in a net
significant emission rate increase as defined in OAR 340-200-0020.
HOW TO COMPLETE A LUeS:
Step Who Does It? What Happens?
I Applicant Applicant completes Section I of the LUCS and submits it to the appropriate city
or county planning office.
2 City or County City or county planning office completes Section 2 ofthe LUCS to indicate
Planning whether the activity or use is compatible with the acknowledged comprehensive
Office plan and land use regulations, attaches written findings supporting the decision of
compatibility, and returns the signed and dated LUCS to the applicant.
3 Applicant Applicant submits the completed LUCS and any supporting information provided
by the city or county to DEQ along with the DEQ permit application or approval
request.
WHERE TO GET HELP: For questions about the LUCS process, contact the DEQ staff responsible for
processing the permit or approval. DEQ staff may be reached at 1-800-452-4011 (toll-free, inside Oregon)
or 503-229-5630. For general questions, please contact DEQ land use staff listed at:
www.deq.state.or.us/pubs/permithandbookllucs.htm.
CULTURAL RESOURCES PROTECTION LA WS: Applicants involved in ground-disturbing activities
should be aware offederal and state cultural resources protection laws. ORS 358.920 prohibits the
excavation, injury, destruction, or alteration of an archeological site or object or removal of
archeological objects from public and private lands without an archeological permit issued by the State
Historic Preservation Office. 16 use 470, Section 106, National Historic Preservation Act of 1966
requires afederal agency, prior to any undertaking, to take into account the effect of the undertaking that
is included on or eligible for inclusion in the National Register. For further information, contact the State
Historic Preservation Office at 503-378-4168, ext. 232.. \ t.-~i
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11/26/08v 08-WR-006
aegon Department of Environmental Qual.
L USE COMPATIBILITY STATEMENT ( S)
p. I of2
SECTION I - TO BE COMPLETED BY APPLICANT
A. Applicant Name: Springfield Dialysis LLC B. Project Name: Q Street Dialysis Clinic
Contact Name: Dr. Mattox Purvis Physical Address: 304 Q Street
Mailing Address: 3385 Riverbend Dr., Suite 200 City, State, Zip: Springfield, OR 97477
City, State, Zip:Springfield, OR 97477 Tax Lot #: 1500 & 1600
Telephone: (541) 485-6851 . Township: 17 Range: 03 Section: 26
Tax Account #: 0218774 Latitude: 44.0624
Longitude: -123.0221
C. Describe the project, include the type of development, business, or facility and services or products provided (attach
additional information if necessary):
Construction ofa new Dialysis clinic as approved on May 28, 2009 as part of the site review DRC2009-00014.
D. Check the type of DEQ permit(s) or approval(s) being applied for at this time.
D Air Quality Notice of Construction D Hazardous Waste Treatment, Storage, or Disposal Permit
D Air Contaminant Discharge Permit (excludes portable D Clean Water State Revolving Fund Loan Request
facility permits) 0 Wastewater/Sewer Construction PlanfSpecifications
D Air Quality Title V Permit (includes review of plan changes that require use of new
D Air Quality Indirect Source Permit land)
D Parking/Traffic Circulation Plan D Water Quality NPDES Individual Permit
D Solid Waste Land Disposal Site Permit D Water Quality WPCF Individual Permit (for ansite
D Solid Waste Treatment Facility Permit construction-installation permits use the DEQ Onsite
D Solid Waste Compost Facility Registration or Permit LUCS form)
D Solid Waste Letter Authorization Permit ~ Water Quality NPDES Stormwater General Permit (J 200-
D Solid Waste Material Recovery Facility Permit A, 1200-C, 1200-CA, 1200-COLS, and 1200-2)
D Solid Waste Energy Recovery Facility Permit 0 Water Quality General Permit (all general permits, except
D Solid Waste Transfer Station Permit 600, 700-PM. l700-A, and 1700-B when they are mobile.)
D Waste Tire Storage Site Permit D Water Quality 401 Certification for federal permit or
D Pollution Control Bond Request license
E. This application is for: D Permit Renewal ~ New Permit D Permit Modification D Other:
SECTION 2 - TO BE COMPLETED BY CITY OR COUNTY PLANNING OFFICIAL
Instructions: Written findings of fact for all local decisions are required; written findings from previous actions are acceptable.
For uses allowed outright by the acknowledged comprehensive plan, DEQ will accept written findings in the form of a reference to
the specific plan policies, criteria, or standards that were relied upon in rendering the decision with an indication of why the
decision is justified based on the plan policies, criteria, or standards.
A. The project proposal is located: ~ Inside city limits o Inside UGB o Outside UGB
B. Name of the city or county that has land use jurisdiction (the legal entity responsible for land use decisions for the subject
property or land use): City of Springfield
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08-WR-006
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a-egon Department of Environmental Qual.
LAW' USE COMPATIBILITY STATEMENT ( S)
p. 2 of 2
SECTION 2 - TO BE COMPLETED BY CITY OR COUNTY PLANNING OFFICIAL
Applicant Name: Springfield Dialysis LLC I Project Name: Q Street Dialysis Clinic
C. Is the activity or use allowed under Measure 49? ~ No, Measure 49 is not applicable o Yes; if yes, then check one:
0 Express; approved by DLCD order #:
0 Conditional; approved by DLCD order #:
0 Vested; approved by local government decision or court judgment docket or order #:
D. Is the activity or use compatible with your acknowledged comprehensive plan as required by OAR 660-03I?
Please complete this form to address the activity or use for which the applicant is seeking approval (see I.C on the previous
page). If the activity or use is to occur in multiple phases, please ensure that your approval addresses the phases described in
l.e. For example, if the applicant's project is described in J.C as a subdivision and the LUCS indicates that only clearing and
grading are allowed outright but does not indicate whether the subdivision is approved, DEQ will delay permit issuance until
approval for the subdivision is obtained from the local planning official.
0 The activity or use is not regulated by the acknowledged comprehensive plan; explain:
0 YES, the activity or use is pre-existing nonconforming use allowed outright by (provide reference for local ordinance):
0 YES, the activity or use is allowed outright by (provide reference for local ordinance):
~ YES, the activity or use received preliminary approval that includes requirements to fully comply with local requirements;
findings are attached.
0 YES, the activity or use is allowed; fmdings are attached.
0 NO, see 2.C above, activity or use allowed under Measure 49; fmdings are attached.
0 NO, (complete below or attach findings for noncompliance and identifY requirements the applicant must comply with
before compatibility can be determined):
Relevant specific plan policies, criteria, or standards:
Provide the reasons for the decision:
Additional comments (attach additional information as needed): Final approval of the site plan requires completion of a Drinking
Water Protection Permit. The applicant is in communication with this office and with the Springfield Utility Board's Drinking
Water Protection Program staff regarding the preparation of the permit. Portions of the permit require the facility to be built to
allow inspection of the storage facilities and the evaluation ofa management plan and training plan to be used for operation of the
site.
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Planning Official Signature: lAw y ~ --
Title: Planner III
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Print Name: Mark Metzger Telephone #:541-726-3775 Date: 07/08/09
If necessary, depending upon city/county agreement on jurisdiction outside city limits but within UGB:
Planning Official Signature: Title:
Print Name: Telephone #: Date:
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08-WR-006