# Prepared by: Stan Cowen Air Quality Engineer 

# Print Name Signature: _ 

# _9 

# ~ ~ 

# Print Title 11 /12/2013 

# Date 805/645-1408

Phone # 

# CALIFORNIA DEPARTMENT OF FISH AND WILDLIFE 

# 2013 ENVIRONMENTAL FILING FEE CASH RECEIPT Complete the information and submit with each set of documents presented for filing. Please provide an original set and (3) three sets of copies for filing. Project Title: Ventura County APCD Rule 74.31 and Amendments to VCAPCD Rule 23 

# Name of Agency filing attached document: Ventura County Air Pollution Control District 

# The above named agency is filing as: Q Lead Agency Q Responsible Agency Q Trustee Agency Address of Filing Agency: 669 County Square Drive, Ventura, CA 93003 DOcument Type (check one): Q Environmental Impact Report 0 Negative Declaration 0 Mitigated Neg. Declaration Q Exemption Project Applicant: Ventura County Air Pollution Control District 

# Project Applicant Address: 669 County Sguare Drive , Ventura, CA 93003 

# Project Applicant Phone Number: 

# (805) 645-1408 Project Applicant is (check one): 0 Local Public Agency Q School District Q Other Special District 0 State Agency OPrivate Entity If the agency presenting this document is filing as the responsible agency, provide a copy of the Lead Agency's filed documents and complete the following: Lead Agency: Lead Agency's Project Title: _ Lead Agency's State Receipt #: Lead Agency's Document #: T Check Applicable Fees (check all that apply): 0 Negative Declaration ($2,156.25) (D Categorically Exempt 0 Environmental Impact Report ($2,995.25) QStatutorily Exempt (D County Administrative Fee ($50.00) © No Effect Determination Form Q Filed by responsible agency; fees paid by lead agency (Attach a copy of Lead Agency's filing & receipt). Q Fees have already been paid (Attach a copy of the prior filing and proof of payment).

DO NOT WRITE BELOW THIS LINE The following will be completed by the Ventura County Clerk's Office. 

# Signature of person receiving payment: , Total Received: $ Deputy County Clerk Posted: through (FW2013)

# VENTURA COUNTY CLERK AND RECORDER Hall of Administration, Main Plaza 800 South Victoria Avenue Ventura, CA 93009 805-654-2295 http://recorder.countyofventura.org MARK A. LUNN CLERK AND RECORDER Receipt for Services Cashier QUELLR Batch 

# # 

# 771733 Customer VENTURA COUNTY AIR POLUTION CONTROL DIST. Date: 

# 11/19/2013 Time: 

# 10:41:43AM

Doc. Type Instrument No GF Number Rec Fees PCOR Sin-vey 

# Fees Taxes Total 

# CEIRE 20131119-10017435-0 50.00 0.00 0.00 0.00 50.00 Total Fee: 

# 50.00 CHECK 1163 50.00 Payment Total: 

# 50.00

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