HomeMy WebLinkAboutItem 4.05 Gateway Med Center PD
CITY CLERK
File # D~[ll]~-LliJ[ll]
AGENDA STATEMENT
CITY COUNCIL MEETING DATE: June 5, 2007
SUBJECT:
P A 06-026, Dublin Gateway Medical Center Building 3 Hospital
and Garage, 2nd Reading - Planned Development Rezone and
Stage 1 and 2 Development Plan and Development Agreement
Report prepared by Mamie R. Nuccio, Associate Planner
ATTACHMENTS: 1) Ordinance adopting a Planned Development Rezone with a
Stage 1 and 2 Development Plan for the Dublin Gateway
Medical Center Building 3 Hospital and Garage Project, with
Stage 1 and 2 Development Plan attached as Exhibit A.
2) Ordinance adopting a Development Agreement for the
Dublin Gateway Medical Center Building 3 Hospital and
Garage Project, with Development Agreement attached as
Exhibit A.
3) Proposed amended Stage 1 and 2 Development Plan in draft
form with amended text shown in strike-through and
underline.
4) Document titled "Dublin City Council Proposed Hospital"
submitted by Gary Sloan, CEO of San Ramon Regional
Medical Center at the May 15,2007 City Council Meeting.
5) Letter dated May 15, 2007 from Weinberg, Roger &
Rosenfeld regarding P A 06-026 Dublin Gateway Medical
Center Building 3 Hospital and Garage.
6) Planning Commission Meeting Minutes of May 8, 2007.
RECOMMENDATION: ~ Waive the 2"' reading and adopt an Ordinance (Attachment
~ 1) for a Planned Development Rezone with a Stage 1 and 2
~ Development Plan for the Dublin Gateway Medical Center
Building 3 Hospital and Garage Project, with Stage 1 and 2
Development Plan attached as Exhibit A; and
2) Waive the 2nd reading and adopt an Ordinance (Attachment
2) for a Development Agreement for the Dublin Gateway
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COpy TO: Applicant, Property Owner
File
Page 1 of 8
ITEM NO.!t !i'"
G:\P A#\2006\06-026 Dublin Gateway Bldg 3 Mod\Public Hearing Documents\CC\CCSR 06-05-07 _final.doc
Medical Center Building 3 Hospital and Garage Project, with
Development Agreement attached as Exhibit A.
FINANCIAL STATEMENT:
None.
PROJECT DESCRIPTION:
Background
The Dublin Gateway Medical Center was approved by the Dublin Planning Commission in 2005 for the
development of approximately 178,000 square feet of medical office uses and a 4-level parking structure
(the "Original Approval") on 7.14 acres of land at the southeast comer of Dublin Boulevard and Tassajara
Road within a portion of the larger 33i: acre Koll Dublin Corporate Center (see Figure 1).
The approvals for the Dublin Gateway Medical Center include the following: two 3-story medical office
buildings; one 3-story lifestyle/wellness center (indoor recreational facility); and a 4-level above ground
parking garage (see Table 1). The Dublin Gateway Medical Center was approved to be developed in two
Phases (Phase One and Phase Two). Phase Two was approved to be developed in sub-phases [Phase Two
(a) and Phase Two (b)] to ensure construction of the parking garage prior to construction of the third
medical office building. Construction of Phase One was completed in January 2007.
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Phase One
120,000
58,000
178,000
Phase Two of the Dublin Gateway Medical Center is the subject of this Staff Report and is a request for
an alternative development project. The alternative project includes the construction of a 6-story, 168,000
square foot, 100-bed hospital and 5-level parking garage with 1 level below ground and 4 levels above
ground (the "Project"). The Project also includes a request to allow for the construction of either the
Original Approval (a 3-story, 58,000 square foot medical office building and 4-level parking garage) or
the Project (a 6-story, 168,000 square foot, 100-bed hospital building and 5-level parking garage) as Phase
Two of the Dublin Gateway Medical Center.
The Project requires approval of a California Environmental Quality Act (CEQA) Addendum, Planned
Development Rezone with amended Stage 1 and 2 Development Plan, a Conditional Use Permit, Site
Development Review and a Development Agreement.
Previous Planning Commission and City Council Meeting
On May 8, 2007, the Planning Commission adopted Resolutions recommending City Council approval of
the Project. On May 15, 2007, the City Council adopted a Resolution approving the CEQA Addendum,
Conditional Use Permit and Site Development Review (subject to the effectiveness of the PD Ordinance)
and waived the readings and introduced Ordinances approving a Planned Development Rezone with Stage
1 and 2 Development Plan and a Development Agreement for the Project.
ANALYSIS:
The item is for the City Council to finalize approval of the Project by adopting the two ordinances that
were introduced at the May 15, 2007 meeting. At the May 15, 2007 City Council hearing, two letters
were submitted during the public comment period, one from Gary Sloan, CEO of San Ramon Regional
Medical Center and the other from Weinberg, Roger & Rosenfeld on behalf of the Service Employees
International Union, United Health Care Workers West ("SEIU-UHW"). This report contains Staff
responses to those letters.
San Ramon Regional Medical Center Letter
Gary Sloan, the CEO of San Ramon Regional Medical Center (see Attachment 4), requested that the City
Council consider the following: 1) whether there is a need for another hospital in the Tri-Valley area; 2)
who the hospital tenant will be and how operations might affect traffic, parking and security; 3) the level
of experience the Project Applicant has in building hospitals; 4) the ambiguous nature of the Project
plans; 5) identification of specific facility needs; and 6) fire and life safety, emergency room access, noise,
loading dock operations, handling of bio-hazardous waste, power, and sewer. Mr. Sloan raised similar
concerns at the May 8, 2007 Planning Commission meeting (see Attachment 6) but did not submit any
written documentation to the Planning Commission. A discussion of the concerns expressed in the letter
submitted to the City Council is addressed below.
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Need for Another Tri-Valley Hospital. Issues raised regarding the need foranother hospital in the Tri-
Valley and the Applicants level of experience in building hospitals are outside the realm of land use and
zoning. However, it may be worth noting that the City of Dublin does not currently have a hospital
facility within its jurisdictional boundary; residents seeking medical care travel to San Ramon Regional
Medical Center in San Ramon, ValleyCare in Pleasanton, Eden Medical Center in Castro Valley or Kaiser
Permanente in Walnut Creek or Hayward. The Project proposes to provide a 100-bed hospital adjacent to
recently constructed medical office buildings in Dublin where currently no such facility exists.
Traffic, Parking and Security. While the Applicant does not currently know who the hospital tenant will
be, Staff has reviewed and analyzed traffic, parking and security as part of the Project. A traffic analysis
was performed by TJKM Transportation Consultants and reviewed by the City's Traffic Engineer. The
analysis concluded that the Project would generate 22 more AM. trips and 21 less P.M. trips resulting in a
net increase of 1 A.M. vehicular trip. Vehicular trip analysis was based on the number of patient beds.
Staff has concluded that a net increase of 1 AM. vehicular trip is not a significant impact on the
community.
With respect to parking, the Project complies with the City's Off-Street Parking and Loading Regulations
for a hospital use which requires 1 parking space for every 3 patient beds, 1 parking space for every doctor
(on the largest shift) and 1 parking space for every 3 employees on the largest shift. Additionally, the
Project proposes to have a surplus of 85 parking spaces above and beyond what the Zoning Ordinance
requires. Furthermore, Conditions of Approval have been applied to the Project to ensure that adequate
parking is provided once a hospital tenant has been selected. Additional parking would be required if
there were an increase in the number of patient beds, an increase in the number of doctors, or an increase
in the number of employees. Changes such as these to the Project would require, at a minimum, an
amendment to the Project's Conditional Use Permit.
The Project has been conditioned to comply with the City of Dublin Non-Residential Security Ordinance
requirements. Additionally, the Conditions of Approval for the Project require that the Applicant work
with Dublin Police Services to establish an effective theft prevention and security program. These
requirements are in addition to any security requirements which may be imposed by the State of California
Office of Statewide Health and Planning Development (OSHPD); OSHPD is the responsible agency for
reviewing and permitting the construction and operation ofthe Project.
Ambiguous Nature of Project Plans. Because a tenant for the Project is currently unknown, the floor
plans for the Project are general; however, the Project approvals are for a 100-bed hospital and the use of
the building is limited to such. The Applicant is aware and has agreed that the construction of a 6-story
building is limited to the Project approvals and cannot be utilized solely for medical office uses without
obtaining additional approvals. Should the Applicant decide to pursue medical offices, a 3-story 58,000
square foot building has already been approved.
Identification of Specific Facility Needs. The specific needs of the facility will be identified once the
hospital user has been selected. OSHPD will review the construction plans and ensure that the size of the
patient rooms and the provision of negative pressure rooms, surgery rooms, laboratory space, radiology
rooms, storage rooms, etc. meet State requirements.
Fire and life safety, emergency room access, noise, loading dock operations, handling of bio-hazardous
waste, power, and sewer. Staff has consulted with Dublin Fire Prevention and Dublin Police Services
during the review of the Project and all comments and Conditions of Approval submitted by these
departments have been incorporated into the Project plans or added as Conditions of Approval. The
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Public Works Department has reviewed access and circulation for the Project including the loading dock
configuration and determined that adequate access and circulation has been proposed. The Project has
been conditioned to provide a loading dock operations plan once a hospital tenant has been identified to
ensure that loading dock operations will comply with the Project as proposed. The environmental review
prepared for the Project adequately and thoroughly analyzed noise and the provision of public services to
the Project and found no significant environmental impacts. The storage, handling and disposal of bio-
hazardous waste are regulated by OSHPD.
Weinberg, Roger & Rosenfeld Letter
The second letter submitted at the May 15, 2007 City Council meeting from Weinberg, Roger &
Rosenfeld on behalf of Service Employees International Union, United Health Care Workers West
("SEIU-UHW") (see Attachment 5) asserted that the Initial Study prepared for the Project did not
adequately address significant impacts related to: 1) hazards and hazardous materials, 2) noise, 3)
aesthetics, 4) seismicity,S) housing, 6) growth inducing impacts, 7) cumulative impacts, and 8)
construction related impacts. The letter also suggests that a supplemental Environmental Impact Report
(EIR) should be prepared. A discussion of the concerns expressed in the letter is addressed below.
Hazardous Materials. SEIU-UHW takes issue with the Initial Study's determination that the Project will
not "create a significant hazard to the public or the environment through the routine transport, use or
disposal of hazardous materials." SEIU-UHW argues that "an emergency room is bound to produce
significant amounts of medical waste" and from that apparently concludes that the mere presence of
hazardous materials at the Project site would constitute a significant impact. It is not the case that the
mere presence of hazardous materials creates a significant hazard. The Initial Study concluded that State
regulations concerning the handling, storage and disposal of hazardous materials would ensure that the
presence of hazardous materials on the site would not "create a significant hazard." With regard to
"medical waste," the proposed hospital would be subject to the Medical Waste Management Act
(California Health and Safety Code sections 117600-118360), which requires generators of medical waste
to obtain permits from an enforcement agency and to comply with State standards for containment and
storage of medical waste.
SEIU-UHW goes on to criticize the failure to impose mitigation measures and in particular the City's
reliance upon the Project's "compliance with State regulations." However, under CEQA, mitigation
measures are only required to mitigate significant impacts. The Initial Study concluded that there would
be no significant hazard created by the project through the routine transport, use or disposal of hazardous
waste (and therefore no associated significant impact) because State regulations strictly regulate the
handling, storage, and disposal of hazardous materials by hospitals. Accordingly, since there is no
significant impact, the City is not obligated by CEQA to mitigate the Project's insignificant impacts. (See
Leonoffv. Monterey County (1990) 222 Cal.App.3d 1337, p. 1356.)
Noise Associated with Ambulances. SEIU-UHW takes issue with the Initial Study's analysis of the noise
associated with ambulance trips coming to the proposed hospital. SEIU-UHW argues that ambulances
coming to the proposed hospital will use sirens and that ambulances that used to go elsewhere will come
to the site of the proposed hospital. SEIU-UHW argues that this new source of noise will impact the
residences 200 feet across Dublin Boulevard from the Project site. The Initial Study noted these impacts
as well but deemed them to be insignificant because of the existence of other adjacent noise sources
(Dublin Boulevard, Tassajara Road, and Interstate 580) and the State law limitations on the use of sirens.
In addition, the residences across Dublin Boulevard are acoustically shielded from traffic noise along
Dublin Boulevard by an 8-foot tall sound wall and through the incorporation of sound rated windows and
doors in order to achieve an indoor noise level of 45 decibels (as required by Eastern Dublin EIR
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Mitigation Measure 3.1012.0). Moreover, the project will pay a noise mitigation fee to pay for on-site and
off-site noise mitigations. Accordingly, the impacts associated with noise from sirens will be less than
significant.
Aesthetics. SEIU-UHW argues that the Initial Study fails to adequately analyze significant impacts related
to aesthetics. SEIU-UHW states that a "more systematic approach" to reviewing aesthetic impacts is
necessary. It then suggests an "accepted approach" to analyzing visual and aesthetic impacts, but by
whom the approach is accepted is not disclosed. In any event, Staff believes that the Initial Study's
analysis, which concludes that the project would result in an aesthetic enhancement of the overall
surroundings, is adequate under CEQA Staffs view, reflected in the Initial Study, is that the project
would not "substantially degrade the existing visual character or quality of the site and its surroundings."
Nothing the SEIU-UHW letter suggests that the Project would substantially degrade the existing visual
character or quality of the site. Finally, where the issue is whether the proposed building is aesthetically
pleasing in the eyes of local residents, that issue is to be resolved in the design review process, not CEQA
(Bowman v. City of Berkeley (2004) 122 Cal.AppAth 572, 593.)
Seismicity. SEIU-UHW asserts that the Initial Study's analysis of the potential impacts due to seismic
events is lacking. SEIU-UHW's assertion fails to recognize the nature of Initial Study's project-level
review. As the introduction to the Initial Study describes, this Project level analysis was prepared for the
purpose of determining "whether there will be any potentially significant site-specific environmental
impacts resulting from the Project which were not examined in previous environmental reviews and if so,
whether those impacts can be reduced to a less-than-significant level through mitigation measures." With
regard to seismicity, the Initial Study notes that the Eastern Dublin EIR had previously considered the
impacts associated with seismicity and adopted mitigation measures to address those potentially
significant impacts. Nonetheless, because the primary effects of groundshaking could not be mitigated to
a less than significant level, a Statement of Overriding Considerations was adopted by the City Council in
1993 when it approve the Eastern Dublin General Plan Amendment and Specific Plan. SEIU-UHW
somehow asserts that the impacts are more significant because of the number of in-patients and caregivers
on site. However, the question under CEQA is not how many people would be exposed to seismicity, but
simply whether "people or structures" would be exposed to seismicity. Thus, the impacts associated with
seismicity are the same as those analyzed in 1993, and contrary to SEIU-UHW's assertions, the intensity
of the use ofthe site has no impact on the significance of those impacts.
Population and Housing. SEIU-UHW asserts that the initial study fails to analyze asserted significant
impacts related to population and housing. SEIU-UHW asserts that the expected generation of 525 new
jobs would create demand to additional housing and, in particular, affordable housing for those working at
the proposed hospital. The Initial Study correctly noted that the increased square footage associated with
the proposed hospital was within the scope of that already analyzed in the Eastern Dublin EIR. Therefore,
the impacts related to population and housing resulting from that commercial square footage and the
associated jobs are no different than that previously analyzed in the Eastern Dublin EIR. Accordingly, the
proposed hospital project will not "induce substantial population growth" beyond that previously analyzed
in the Eastern Dublin EIR. It should also be noted that the City has an inclusionary housing program that
results in the creation of a number of affordable units and that developers will be required to pay the
City's non-residential affordable housing fee, which generates revenue to create new affordable housing in
the City.
Growth-Inducing Impacts and Cumulative Impacts. SEIU-UHW asserts, separately, that the Initial Study
fails to consider significant growth-inducing impacts and cumulative impacts. Once again, SEIU-UHW's
assertions are based on the mistaken premise that the project proposes something that is beyond the scope
of that previously analyzed in the Eastern Dublin EIR. The Eastern Dublin EIR previously analyzed the
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growth-inducing impacts and cumulative impacts of development in Eastern Dublin, and the square
footage associated with the proposed Project is within the scope of that previous analysis. Nothing in the
SEIU-UHW's letter suggests that there is anything in particular about this Project site or the Project itself
that would lead to impacts that were not previously analyzed.
Construction-Related Noise and Air Quality Impacts. SEIU-UHW asserts that the Initial Study fails to
properly analyze the construction-related noise and air-quality impacts associated with the increase in size
from the previously approved medical office building. Once again, SEIU-UHW's assertion fails to
recognize that the construction-related impacts are no different than the impacts previously analyzed in the
Eastern Dublin EIR.
Construction Noise. SEIU-UHW provides no evidence or discussion beyond its bare assertion that
the project will involve a substantial increase in significant construction noise impacts. The City notes
that the Eastern Dublin EIR identified and analyzed Impact 3/1 OlE, the potential for significant
construction noise exposure to existing and proposed residences from development consistent with the
general plan and Eastern Dublin Specific Plan. As noted in the Initial Study, adopted mitigation measure
3.10/4.0 requires developers to prepare a Construction Noise Management Program, to include features
such as a grading schedule limiting grading activities, hours of grading, and construction vehicle access
through residential neighborhoods. The previously adopted mitigation applies to development in Eastern
Dublin, such as the project, and is implemented through proposed Conditions of Approval Nos. 92, 93 and
94. The proposed development is consistent with the development assumptions in the Eastern Dublin
EIR; the commenter provides no evidence that additional review is necessary under CEQA section 21166
(and related Guidelines sections 15162, 15163).
Construction Emissions. SEIU-UHW asserts various construction air quality impacts but
continues to misunderstand the focus of subsequent review under CEQA and impacts previously
analyzed. Construction particulates, equipment and vehicle emissions ranging from minor emissions to
substantial emissions of NO X from diesel-powered equipment are analyzed in Impacts 3.11/ A and 3.11/B
of the Eastern Dublin EIR. Related mitigations 3.11/1.0, 2.0, 3.0 and 4.0 were adopted to reduce the
identified impacts to less than significant, but cumulative impacts would remain unavoidable and a
Statement of Overriding Considerations was adopted upon approval of the Eastern Dublin General Plan
Amendment and Specific Plan. The adopted mitigation measures call for comprehensive dust control
measures during construction, limiting construction activities to active construction areas, limiting
interference with non-construction traffic, and preparing a construction impact reduction plan to
incorporate all proposed air quality mitigation strategies. These mitigations are implemented through
numerous Conditions of Project Approval, including but not limited to Nos. 63, 68, 92, 94 and 111.
The findings of the Initial Study that the project would have no significant construction air quality impacts
beyond those previously identified is also consistent with the Bay Area Air Quality Management District
(BAAQMD) CEQA Guidelines as to thresholds of significance for construction impacts
(http://www.baaqmd.gov/pln/ceqa/index.htm). Construction air quality impact analysis is addressed in
Sections 2.3,3.3,4.2 of the BAAQMD guidelines. The District does not identify quantified standards for
construction emissions, instead focusing on implementation of dust and emissions control measures. The
adopted mitigation measures from the Eastern Dublin EIR and implementing Conditions of Approval
substantially include the basic and some enhanced feasible dust control measures recommended by the
District in Table 2 of the Guidelines. With implementation ofthese control measures, the project would
have no significant construction emissions impact beyond those previously identified. The more recent
identification of PM 2.5 standards would not change this conclusion since particulate emissions were
found significant and unavoidable in the Eastern Dublin EIR.
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With respect to the other emissions mentioned by the commenter, the BAAQMD CEQA Guidelines
Section 2.3, note 3 states as follows: "Construction equipment emits carbon monoxide and ozone
precursors. However, these emissions are included in the emission inventory that is the basis for regional
air quality plans, and are not expected to impede attainment or maintenance of ozone and carbon
monoxide standards in the Bay Area." Therefore, under the District's CEQA Guidelines for analyzing air
quality impacts, no quantification of construction emissions, including carbon monoxide or ozone
precursors is required.
ENVIRONMENTAL REVIEW:
Pursuant to the California Environmental Quality Act (CEQA), an Initial Study has been prepared for the
Project and a determination has been made that the proposed Project will not have a significant effect on
the environment. The project has been found to be within the scope of the Program EIR for the Eastern
Dublin General Plan Amendment and Specific Plan (the "Eastern Dublin EIR") (SCH No. 91103064); the
Santa Rita Property Mitigated Negative Declaration (the "Santa Rita Property MND") (SCH No.
96082092); and, the Dublin Ranch West Environmental Impact Report (the "Dublin Ranch West EIR")
(SCH No. 2004112094). Together, the Eastern Dublin EIR, Santa Rita Property MND, and the Dublin
Ranch West EIR, adequately describe the total Project for the purpose of CEQA In accordance with
CEQA Guidelines Sections 15162 and 15164 an Addendum has been prepared.
RECOMMENDATION:
Staff recommends that the City Council: 1) Waive the 2nd reading and adopt an Ordinance (Attachment
1) for a Planned Development Rezone with a Stage 1 and 2 Development Plan for the Dublin Gateway
Medical Center Building 3 Hospital and Garage Project, with Stage 1 and 2 Development Plan attached as
Exhibit A and 2) Waive the 2nd reading and adopt an Ordinance (Attachment 2) for a Development
Agreement for the Dublin Gateway Medical Center Building 3 Hospital and Garage Project, with
Development Agreement attached as Exhibit A
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Ie:{ l?~
ORDINANCE NO. XX - 07
AN ORDINANCE OF THE CITY COUNCIL
OF THE CITY OF DUBLIN
APPROVING A PLANNED DEVELOPMENT REZONE AND STAGE 1 AND 2
DEVELOPMENT PLAN FOR THE DUBLIN GATEWAY MEDICAL CENTER BUILDING 3
HOSPITAL AND GARAGE PROJECT LOCATED AT 4084 AND 4100 DUBLIN BOULEVARD
APN 986-0016-021 & 986-0016-022
P A 06-026
THE CITY COUNCIL OF THE CITY OF DUBLIN DOES HEREBY ORDAIN AS FOLLOWS:
Section 1. RECITALS
A By Ordinance No. 22-98 the City Council rezoned the approximately 35-acre area known
as Koll Dublin Corporate Center to a Planned Development Zoning District and adopted a Stage 1 and 2
Development Plan for the entire proj ect area.
B. This Ordinance adopts an amendment to the Stage 1 and 2 Development Plan approved for
the Koll Dublin Corporate Center by the City Council on December 15, 1998.
Section 2.
FINDINGS AND DETERMINATIONS
A. Pursuant to Section 8.32.070 ofthe Dublin Municipal Code, the City Council finds as follows:
1. The Planned Development Rezone and amended Stage 1 and 2 Development Plan for the
Dublin Gateway Medical Center Building 3 Hospital and Garage project (the "Project"), meets
the purpose and intent of Chapter 8.32 in that it provides maximum flexibility and
diversification in the development of the property by allowing the development of either a
58,000 square foot medical office building or a 168,000 square foot, 100-bed hospital building
depending upon market conditions and creates a desirable use of land that is sensitive to
surrounding land uses by virtue of the layout and design, which is in close proximity to Dublin
Boulevard, Tassajara Road and the 1-580 freeway.
2. The Planned Development Rezone and amended Stage 1 and 2 Development Plan for the
Project will be harmonious and compatible with existing and future development in the
surrounding area because: 1) the uses proposed as part of the Project are consistent with the
1998 Development Plan approved for the Koll Dublin Corporate Center; and 2) the Project is
consistent with campus office development as envisioned in the Eastern Dublin Specific Plan.
B. Pursuant to Section 8.120.050.A and B of the Dublin Municipal Code, the City Council finds as
follows:
1.
The Planned Development Rezone and amended Stage 1 and 2 Development Plan for the
Project will be harmonious and compatible with existing and potential development in the
surrounding area in that: 1) the land uses and site plan establish a comprehensive medical
office complex; 2) the Project is consistent with the Eastern Dublin Specific Plan and the Stage
1 and 2 Development Plan, as amended; 3) the Project site has been designed to be compatible
with adjacent professional and medical office uses and commercial uses; and 4) the Project site
includes attractive landscaping and site elements including a location for public art, light
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ATTACHMENT 1 (}
Page 1 of3
2- 1 l z.. '2--
fixtures, benches, plazas and pedestrian paths to create an attractive landscape palette and
material palette for the hospital and adjacent medical office buildings.
2. The Project site is physically suitable for the type and intensity of the zoning district being
proposed in that: 1) the Project, in combination with the larger Koll Dublin Corporate Center,
will not exceed the maximum Floor Area Ratio (FAR) of .80 which was established in the
Eastern Dublin Specific Plan for Campus Office land uses; 2) the Project will include a
hospital use which is consistent with the land use designations of General Commercial and
Campus Office; 3) as amended, the Stage 1 and 2 Development Plan will permit a maximum
of 168,000 square feet of gross floor area for a hospital; and 4) the Stage 1 and 2 Development
Plan for the Project has been designed to accommodate the topography of the Project site
which is currently developed with surface parking and landscaping and is suitable for the
development of a hospital and therefore physically suitable for the type and intensity of the
proposed Planned Development Zoning district.
3. The Planned Development Rezone and amended Stage 1 and 2 Development Plan for the
Project will not adversely affect the health or safety of persons residing or working in the
vicinity or be detrimental to the public health, safety and welfare because the Project will
comply with all applicable development regulations and standards and will implement all
adopted mitigation measures.
4. The Planned Development Rezone and amended Stage 1 and 2 Development Plan for the
Project is consistent with the Dublin General Plan, Eastern Dublin Specific Plan and the
Planned Development Zoning, as amended, in that: 1) the Project is consistent with the
permitted, conditional and temporary use lists adopted by the City Council as part of the 1998
Stage 1 and 2 Development Plan for the Koll Dublin Corporate Center; 2) the proposed
amendments to the Stage 1 and 2 Development Plan with respect to density provides for
flexibility in development depending upon market conditions by allowing for either a 58,000
square foot medical office building or a 168,000 square foot hospital building on Lot 3 of Map
8524; and 3) the Project is consistent with the purpose and intent of the Eastern Dublin
Specific Plan for the Tassajara Gateway subarea which encourages the development of land
uses that will benefit from their location at the intersection of Dublin Boulevard and Tassajara
Road and their close proximity to the 1-580 freeway.
C. Pursuant to the California Environmental Quality Act, the City Council finds as follows:
1. Pursuant to the California Environmental Quality Act (CEQA), Sections 15162 and 15164
provide that an addendum to a previously certified Environmental Impact Report (EIR) may be
prepared when a proj ect requires a minor technical change to an EIR and there are no new
significant environmental effects and no substantial increase in the severity of previously
identified significant effects.
Section 3. MAP OF THE PROPERTY.
Pursuant to Chapter 8.32, Title 8 of the City of Dublin Municipal Code, the Stage 1 and 2 Development
Plan applies to the following property ("the Property"):
Lot 3 and 4 of Vesting Tentative Parcel Map 8524, 1.545 acres and 1.585 acres respectively (also
a portion of Lot 7 of Tract 7064) for PA 06-026 (APN 986-0016-021 & 986-0016-022) at the
southwest comer of Dublin Boulevard and Glynnis Rose Drive and bordered by Dublin Boulevard
to the north, Glynnis Rose Drive to the west and Koll Center Drive to the south.
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3c:f
A vicinity map showing the area for a Stage 1 and 2 Development Plan is shown below:
Section 4. APPROVAL
The regulations for the use, development, improvement, and maintenance of the Property are set forth in
the amended Stage 1 and 2 Development Plan as attached in Exhibit A which is hereby approved. Any
amendments to the Stage 1 and 2 Planned Development Zoning Development Plan shall be in accordance
with Section 8.32.080 and/or Chapter 8.120 of the Dublin Municipal Code or its successors.
Section 5. EFFECTIVE DATE AND POSTING OF ORDINANCE
This Ordinance shall take effect and be in force thirty (30) days from and after the date of its
passage. The City Clerk of the City of Dublin shall cause the Ordinance to be posted in at least three (3)
public places in the City of Dublin in accordance with Section 36933 of the Government Code of the
State of California.
PASSED, APPROVED AND ADOPTED BY the City Council of the City of Dublin, on this 5th
day of June 2007 by the following vote:
AYES:
NOES:
ABSENT:
ABSTAIN:
Janet Lockhart, Mayor
ATTEST:
City Clerk
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Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (PA 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25, 2005 (P A 04-046)
Amended by Ordinance _-_ by the City Council on _, 2007 (P A 06-026)
EXHIBIT A
DEVELOPMENT PLAN
General Provisions
This is a Development Plan pursuant to Chapter 8.32 of the Dublin Zoning Ordinance for
the Koll Corporate Center project, located on the south side of Dublin Boulevard, east of
Tassajara Creek, West of Tassajara Road, and north of Interstate 580 (APN 986-0001-001-
10, portion). This Development Plan meets all of the requirements for Stage 1 and Stage 2
review of the project.
This Development Plan was subsequently amended by Planning Commission Resolution
04-55 for the Ulferts Center project on August 24, 2004. The amendments included the
removal of the hotel designation on Lots 1 and 2 and allowed for the development of retail
commercial uses on the entire property.
This Development Plan was subsequently amended for the Dublin Gateway Medical Center
project on January 25, 2005. The amendment allowed for massage establishments in
conjunction with physical therapy to be a permitted use, rather than conditional use,
consistent with the regulations set forth in the Dublin Zoning Ordinance.
This Development Plan was subsequently amended for the Dublin Gateway Medical Center
Building 3 Hospital and Garage project on _, 2007. The amendments allowed for am
alternative development project on a portion of Lot 7 of Map 7064 otherwise known as
Lots 3 & 4 of Map 8524; an increase in square footage on Lot 7 of Map 7064; revisions to
the site plan and landscape plan; and, revisions to the development regulations.
This Development Plan is also represented by the following:
· Tentative Map 7064 and Site Development Review plans, Landscape plans, and other
plans, exhibits, and written statements contained in the document dated received October
30, 1998, labeled Exhibit A-I to the Ordinance approving this Development Plan (City
Council Ordinance No. 22-98), on file in the Planning Division.
· Site Development Review plans, Landscape plans, and other plans, exhibits and written
statements relating to the project approved as part of Planning Commission Resolution
04-55 for the Ulferts Center (P A 03-064), on file in the Planning Division.
· Tentative Map 8524 and Site Development Review plans, Landscape plans, and other
plans, exhibits and written statements relating to the project approved as part of Planning
Commission Resolution 05-06 for the Dublin Gateway Medical Center (P A 04-046), on
file in the 'Planning Division.
· Site Development Review plans, Landscape plans, and other plans, exhibits and written
statements relating to the project approved as part of Ordinance _ for the Dublin
Gateway Medical Center Building 3 Hospital and Garage (P A 06-026), on file in the
Planning Division.
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Exhibit A
[) 1 122.--'
Amended by Resolution 04-55 by the Planning Commission on August 24, 2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25,2005 (PA 04-046)
Amended by Ordinance _-_ by the City Council on _, 2007 (P A 06-026)
This Planned Development Zoning District, as amended, allows the flexibility needed to
encourage innovative development while ensuring that the goals, policies, and action programs
of the General Plan, Eastern Dublin Specific Plan, and provisions of Section 8.32 of the Zoning
Ordinance are satisfied.
1. Permitted Uses. The following uses are permitted for this "PD / C-2 / C-O" (Planned
Development/General Commercial/Campus Office) Zoning District. *
a) Banks & Financial Services;
b) Contractor's Office;
c) Copying & Blueprinting;
d) Eating & Drinking Establishments;
e) Health Services/Clinics;
f) Laboratory;
g) Professional/ Administrative Offices;
h) Parking Lot/Garage - Commercial;
i) Retail- General;
j) Retail- Neighborhood;
k) Retail - Service;
I) Day Care of 14 or fewer children;
m) School- trade school, college, university;
n) Similar and related uses as determined by the Director of Community
Development; and,
0) Massage Establishments, in conjunction with physical therapy.
Amended by PC Reso. 05-06 (01/25/05)
*See "**NOTE" on Page 5 regarding uses on Lot 3 of Map 8524.
2. Conditional Uses. *
a) AutomobileN ehicle Brokerage, Rental;
b) Building Materials Sales;
c) Mini-Storage;
d) Storage of petroleum products for on-site use;
e) Warehousing and distribution;
f) Community Facility;
g) Massage Establishments, in conjunction with a gymnasium/health club;
Amended by PC Reso. 05-06 (01/25/05)
h) Day Care Center - 15+ children;
i) Outdoor Mobile Vendor;
j) Outdoor Seating;
k) Temporary Outdoor Sale not related to on-site established business (sidewalk
sale);
I) Caretaker Residence;
m) Hospital/Medical Center;
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b ~ 12"'2.--'
Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25,2005 (PA 04-046)
Amended by Ordinance _-_ by the City Council on _' 2007 (P A 06-026)
n) Animal Sales and Services;
0) Auction Yard;
p) AutomobileN ehicle Sales and Service;
q) Bed and Breakfast inn;
r) Car Wash/Detailing;
s) Community Care Facility - Large;
t) Dance Floor;
u) Drive-in/Drive-through business;
v) Hotel/Motel;
w) Plant Nursery;
x) Recreational Facility/Indoor;
y) Recreational Facility/Outdoor;
z) Retail- outdoor storage;
aa) Service Station;
bb) Shopping Center; and,
cc) Similar and related uses as determined by the Director of Community
Development.
*See n**NOTE" on Page 5 regarding uses on Lot 3 of Map 8524.
3. Dublin Zoning Ordinance, Applicable Requirements. Except as specifically modified
by the provisions of this PD District Rezone/Development Plan, all applicable general
requirements and procedures of the Dublin Zoning Ordinance shall be applied to the land
uses designated in this PD District Rezone.
4. Site Plan & Architecture. This Development Plan applies to the approximately 37-acre
site generally located south of Dublin Boulevard, north of Interstate 580, west of
Tassajara Road and east of John Monego Court.
Any modifications to the project, or development on the future hotel/retail site (Phase 3),
shall be substantially consistent with these plans and of equal or superior materials and
design quality. Development on the future hotel/retail site (Phase 3) requires approval of
Site Development Review by the City of Dublin. The development of the future
hotel/retail site (Phase 3) was modified by Planning Commission Resolution 04-55 for
the Ulferts Center.
The following site plans and elevations are hereby incorporated by reference:
Amended by Ord. _ -_ (Date)
· Ordinance 22-98 for the Koll Dublin Corporate Center, Exhibit A-I (P A 98-047).
· Planning Commission Resolution 04-55 for the Ulferts Center (P A 03-064).
· Planning Commission Resolution 05-06 for the Dublin Gateway Medical Center
(P A 04-046).
· Ordinance _-_ and Planning Commission Resolution _-_ for the Dublin
Gateway Medical Center Building 3 Hospital and Garage (P A 06-026).
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-7 ~
Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (PA 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25, 2005 (P A 04-046)
Amended by Ordinance _-_ by the City Council on _, 2007 (P A 06-026)
5. Density. The maximum square footage of the proposed development for the parcels
covered under this Development Plan (as shown on the applicable site plans) is as
follows:
Lot 1 & 3, Tract 7064 (Retail site):
1.6 acres & 2.6 acres, respectively
50,530 square feet building area*
Amended by PC Reso. 04-55 (August 24, 2004)
Lot 2, Tract 7064 (Retail site):
1.6 acres
7,000 square feet building area*
Lot 4, Tract 7064 (4-story office building):
5.53 acres
139,285 square feet building area
Lot 5, Tract 7064 (4-story office building):
6.67 acres
139,285 square feet building area
Lot 6, Tract 7064 (4-story office building):
6.42 acres
139,285 square feet building area
Lot 7, Tract 7064:
7.11 acres
Lot 7 of Tract 7064 has been further divided as follows:
Amended by CDD Reso. 05-01 (February 28, 2005)
Amended by PC Reso. 05-06 (January 25, 2005)
Amended by Ord. - (Date)
Lot 1, Map 8524 (3-story office building)
3.000 acres
62,300 square feet building area
Lot 2, Map 8524 (3-story office building)
1.009 acres
57,700 square feet building area
Lot 3, Map 8524 (3-story office building) 1.545 acres
58,000 square feet building area OR 168,000 square feet building area**
Lot 4, Map 8524
1.585 acres
4-level parking garage OR 5-level parking garage**
Total Building Area: 178,000 square feet OR 292,000 square feet**
Lot 8, (Park & Ride facility):
1. 74 acres
No building area (parking only)
*NOTE: Densities for Lots 1, 2, and 3 may be combined and re-allocated among these
three lots in any manner within this portion of the project site, but must be used for
General Commercial/Retail uses and a hotel, unless an amendment to this Planned
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~ 0;/.
Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25, 2005 (P A 04-046)
Amended by Ordinance _ -_ by the City Council on _, 2007 (P A 06-026)
Development is approved. An amendment to the Planned Development was approved
by Planning Commission Resolution 04-55 on August 24, 2004. This amendment
removed the hotel designation from Lots 1 and 3 and allowed for the development of
retail commercial uses instead.
**NOTE: This Development Plan allows for the development of either: 1) a 3-story,
58,000 square foot medical office building on Lot 3 of Map 8524 and 4-level above
ground parking garage on Lot 4 of Map 8524 OR 2) a 6-story, 168,000 square foot, 100-
bed hospital on Lot 3 of Map 8524 and 5-1evel parking garage on Lot 4 of Map 8524 with
one level below ground and 4-levels above ground. At no time shall the 6-story hospital
building on Lot 3 of Map 8524 be utilized for any other use than a hospital without an
amendment to this Development Plan.
6. Phasing Plan. The Corporate Center will be developed in three phases. The First phase
will include the three, four-story office buildings, Park & Ride lot, perimeter landscaping,
on-site entrance roads, and associated site work. The Second phase will be the signature,
six-story office building at the comer of Dublin Boulevard and Tassajara Road (Amended
by Planning Commission Resolution 05-06 on January 25,2005). The Third phase will
include the HotellRetail parcel, which will likely be sold to a separate hotel developer
(Amended by Planning Commission Resolution 04-55 on August 24, 2004). Third
phase uses could be constructed after the first phase when a critical mass of on-site
customer support is created. Any hotel/retail uses proposed for the vacant parcel (Lots 1,
2, and 3) must be consistent with the standards established by this Development Plan, and
will require approval of a Site Development Review by the City of Dublin Planning
Commission (Amended by Planning Commission Resolution 04-55 on August 24,
2004).
7. Landscaping Plan. The following landscaping plans are hereby incorporated by
reference:
· Ordinance 22-98 for the Koll Dublin Corporate Center, Exhibit A-I (PA 98-047).
· Pinewave Design and Engineering, 3 sheets, dated received by the Planning
Division on August 17,2004 for the Ulferts Center (PA 03-064). Amended by
PC Reso. 04-55 (August 24, 2004)
· Ware Malcomb, 3 sheets, dated received by the Planning Division on January 11,
2005 for the Dublin Gateway Medical Center (P A 04-046). Amended by PC
Reso. 05-06 (01/25/05)
· Ware Malcomb and Ridge Landscape Architects, dated received by the Planning
Division on February 26,2007 for the Dublin Gateway Medical Center Building
3 Hospital and Garage (P A 06-026). Amended by Ord. _ -_ (Date)
8. Development Standards. The development regulations for the project are hereby
incorporated by reference:
· Ordinance 22-98 for the Koll Dublin Corporate Center, Exhibit A-I (P A 98-047).
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q~
Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25,2005 (PA 04-046)
Amended by Ordinance _-_ by the City Council on _' 2007 (P A 06-026)
. Pinewave Design and Engineering dated received by the Planning Division on
August 17, 2004 for the Ulferts Center (PA 03-064). Amended by PC Reso. 04-
55 (August 24, 2004)
. Ware Malcomb, dated received by the Planning Division on January 11,2005 for
the Dublin Gateway Medical Center (P A 04-046). Amended by PC Reso. 05-06
(01/25/05)
. Ware Malcomb, dated received by the Planning Division on February 26, 2007
for the Dublin Gateway Medical Center Building 3 Hospital and Garage (P A 06-
026). Amended by Ord. _ -_ (Date)
The development of Lots 3 and 4 of Parcel Map 8524 (formerly a portion of Lot 7 of
Tract Map 7064) shall be permitted to have:
. A 3-story, 58,000 square foot medical office building (Lot 3) and 4-level above
ground parking garage (Lot 4) approved as part of Planning Commission
Resolution 05-06, OR
. A 6-story, 168,000 square foot, 100-bed hospital building (Lot 3) and 5-level
parking garage (Lot 4) with one level below ground and 4 levels above ground
approved as part of Ordinance _ and Planning Commission Resolution _'
The 5-level parking garage approved in conjunction with the 6-story hospital building
may also be constructed with the 3-story medical office building so long as one level of
parking remains underground and only 4-levels of parking above ground.
NOTE: Any increase in the maximum square footage on Lot 3 of Map 8524, including
the addition of a basement for equipment or any other use, shall require an amendment to
this Development Plan and shall be subject to review by the Planning Commission with a
recommendation to City Council.
9. General Provisions.
A) The project applicant/developer shall enter into a Development Agreement with the
City of Dublin prior to Final Map approval, which shall contain, but not be limited
to, provisions for financing and timing of on and off-site infrastructure, payment of
traffic, noise and public facilities impact fees, ownership and maintenance of creek
and open space areas, and other provisions deemed necessary by the City to find the
project consistent with the Eastern Dublin Specific Plan.
B) The project applicant/developer shall be required to pay a Public Facilities Fee in the
amounts and at the times set forth in City of Dublin Resolution No. 32-96, adopted
by the City Council on March 26, 1996, or in the amounts and at the times set forth
in any resolution revising the amount of the Public Facilities Fee.
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)0 ~, l ~L./
ORDINANCE NO. XX - 07
AN ORDINANCE OF THE CITY COUNCIL
OF THE CITY OF DUBLIN
APPROVING A DEVELOPMENT AGREEMENT FOR THE DUBLIN GATEWAY MEDICAL
CENTER BUILDING 3 HOSPITAL AND GARAGE PROJECT LOCATED AT
4084 AND 4100 DUBLIN BOULEVARD
APN 986-0016-021 & 986-0016-022
P A 06-026
THE CITY COUNCIL OF THE CITY OF DUBLIN DOES HEREBY ORDAIN AS FOLLOWS:
Section 1. RECITALS
A The Dublin Gateway Medical Center Building 3 Hospital and Garage project (the
"Project") is located within the boundaries of the Eastern Dublin Specific Plan ("Specific Plan") in an
area designated Campus Office on the General Plan Land Use Element Map and Eastern Dublin Specific
Plan Land Use Map with an allowance for General Commercial land uses pursuant to Planned
Development Zoning.
B. Pursuant to the California Environmental Quality Act (CEQA), Sections 15162 and 15164
provide that an addendum to a previously certified Environmental Impact Report (EIR) may be prepared
when a project requires a minor technical change to an EIR and there are no new significant
environmental effects and no substantial increase in the severity of previously identified significant
effects.
C. A public hearing on the proposed Development Agreement was held before the Planning
Commission on April 24, 2007 and May 8,2007, for which public notice was given as provided by law.
D. The Planning Commission has made its recommendation to the City Council for approval
of the Development Agreement.
F. A public hearing on the proposed Development Agreement was held before the City
Council on May 15, 2007 and June 5, 2007 for which public notice was given as provided by law.
G. The City Council has considered the recommendation of the Planning Commission who
considered the item at the April 24, 2007 and May 8, 2007 meetings, including the Planning
Commission's reasons for its recommendation, the Agenda Statement, all comments received in writing
and all testimony received at the public hearing.
Section 2.
FINDINGS AND DETERMINATIONS
Therefore, on the basis of (a) the foregoing Recitals which are incorporated herein, (b) the City of
Dublin's General Plan, (c) the Eastern Dublin Specific Plan, (e) the Eastern Dublin EIR, (d) the 1996
Mitigated Negative Declaration for the Santa Rita Property, (e) the CEQA Addendum (f) the Agenda
Statement, and on the basis of the specific conclusions set forth below, the City Council finds and
determines that:
Page 1 of3
Attachment 2
({ 1-
1. The Project is consistent with the objectives, policies, general land uses and programs
specified and contained in the City's General Plan and in the Eastern Dublin Specific Plan in that: (a) the
General Plan and Specific Plan land use designations for the Project site are Campus Office with an
allowance for General Commercial land uses pursuant to Planned Development Zoning and the proposed
Project is a project consistent with those land uses; (b) the Project, as conditioned, is consistent with the
fiscal policies of the General Plan and Specific Plan with respect to provision of infrastructure and public
services; (c) the Project is consistent with the Stage 1 and 2 Planned Development Zoning Development
Plan adopted for the Koll Dublin Corporate Center in 1998 by the City Council, as amended for the
Project and approved by the City Council; and (d) the Triad Dublin Gateway L.P. Development
Agreement includes provisions relating to vesting of development rights, and similar provisions set forth
in the Specific Plan.
2. The Triad Dublin Gateway L.P. Development Agreement is compatible with the uses
authorized in, and the regulations prescribed for, the land use districts in which the real property is located
in that the Project approvals include Planned Development Rezone and amended Stage 1 and 2
Development Plan, Conditional Use Permit and Site Development Review.
3. The Triad Dublin Gateway L.P. Development Agreement is in conformity with public
convenience, general welfare and good land use policies in that the Project will implement land use
guidelines set forth in the Eastern Dublin Specific Plan and the General Plan which have planned for
campus office and general commercial uses at this location.
4. The Triad Dublin Gateway L.P. Development Agreement will not be detrimental to the
health, safety and general welfare in that the Project will proceed in accordance with all the programs and
policies of the Eastern Dublin Specific Plan.
5. The Triad Dublin Gateway L.P. Development Agreement will not adversely affect the
orderly development of property or the preservation of property values in that the Project will be
consistent with the General Plan and with the Eastern Dublin Specific Plan.
Section 3. APPROVAL
The City Council hereby approves the Development Agreement attached hereto as Exhibit A and
authorizes the Mayor to execute it.
Section 4. RECORDATION
Within ten (10) days after the Development Agreement is fully executed by all parties, the City
Clerk shall submit the Agreement to the County Recorder for recordation.
Section 5. EFFECTIVE DATE AND POSTING OF ORDINANCE
This Ordinance shall take effect and be in force thirty (30) days from and after the date of its
passage. The City Clerk of the City of Dublin shall cause the Ordinance to be posted in at least three (3)
public places in the City of Dublin in accordance with Section 36933 of the Government Code of the
State of California.
Page 2 of3
12-~
PASSED, APPROVED AND ADOPTED BY the City Council of the City of Dublin, on this 5th
day of June 2007 by the following vote:
AYES:
NOES:
ABSENT:
ABSTAIN:
Mayor
ATTEST:
City Clerk
G:\PA#\2006\06-026 Dublin Gateway Bldg 3 Mod\Public Hearing Documents\CC\CC Ord DA_done.doc
Page 3 of3
RECORDING REQUESTED BY:
CITY OF DUBLIN
When Recorded Mail To:
City Clerk
City of Dublin
100 Civic Plaza
Dublin, CA 94568
Fee waived per GC 27383
I~~
Space above this line for Recorder's use
DEVELOPMENT AGREEMENT
BETWEEN THE
CITY OF DUBLI N
AND
TRIAD DUBLIN GATEWAY, L.P.
FOR THE DUBLIN GATEWAY MEDICAL CENTER PROJECT
(HOSPITAL ALTERNATIVE)
EXHIBIT A
/41,
THIS DEVELOPMENT AGREEMENT ("Agreement") is made and entered
in the City of Dublin on this 15th day of May, 2007, by and between the City of
Dublin, a Municipal Corporation (hereafter "City"), and Triad Dublin Gateway,
L.P., a California limited partnership (hereafter "Developer"), pursuant to the
authority of SS 65864 et seq. of the California Government Code and Dublin
Municipal Code, Chapter 8.56.
RECITALS
A. California Government Code SS 65864 et seq. and Chapter 8.56 of
the Dublin Municipal Code (hereafter "Chapter 8.56") authorize the City to enter
into an agreement for the development of real property with any person having a
legal or equitable interest in such property in order to establish certain
development rights in such property; and
B. Developer owns fee title to four separate legal parcels of real
property consisting of approximately 7.139 acres located in the City of Dublin,
County of Alameda, State of California. These four parcels are sometimes
referred to individually herein as Parcel 1, Parcel 2, Parcel 3 and Parcel 4,
respectively. The property subject to this Agreement consists of Parcel 3 and
Parcel 4, the size of which is 3.13 total acres and which is legally described in
Exhibit A attached hereto (the "Property"). Parcel 1, Parcel 2, Parcel 3 and
Parcel 4 are sometimes each individually referred to herein as a "Parcel" and
collectively as the "Parcels"; and
C. On February 28,2005, the City granted a Vesting Tentative Parcel
Map for Tract 8524 for Dublin Gateway Medical Center (Community
Development Director Resolution No. 05-01) and on January 25, 2005, the City
granted a Conditional Use Permit (Planning Commission Resolution No.05-06)
and Site Development Review (Planning Commission Resolution No.05-06) for
the development of the Parcels (these approvals are hereinafter collectively
referred to as the "Original Approvals"). Under these Original Approvals, the
original plan was to develop the Parcels in two phases, with Phase I consisting of
two medical/professional office buildings totaling approximately 120,000 square
feet, and Phase II consisting of a third approximately 58,000 square-foot
medical/professional office building of three stories and a 427 -space, 4-level
parking structure. Building 1 on Parcel 1 is approximately 65,295 square feet,
Building 2 on Parcel 2 is approximately 57,786 square feet and Building 3 on
Parcel 3 is approximately 58,000 square feet. Phase I and Phase II of the
project, as configured under the Original Approvals, are depicted on the Site Plan
attached hereto as Exhibit C. The plan proposed by the Original Approvals is
commonly referred to as the "Dublin Gateway Medical Center"; and
D. Developer has completed construction of Phase I contemplated
under the Original Approvals. Developer now desires to provide for an alternate
Dublin/Triad Dublin Gateway, L.P. Development Agreement Page 2 of 16
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Phase II development plan, which will provide the Developer with the flexibility to
develop either the original Phase II plan, as described in Recital C (the "Original
Plan") or the alternate Phase II development plan (the "Alternate Plan"). The
Alternate Plan consists of a six-story, approximately 168,000 square-foot, 100-
bed hospital building and a five-level parking structure, of which one level will be
located below-ground. The Site Plan for the Alternate Plan, which also depicts
Phase I of the Project, is attached hereto as Exhibit D. Developer has applied
for, and City has approved or is processing various land use approvals in
connection with the Alternate Plan, including a Conditional Use Permit (City
Council Resolution No. _), a Site Development Review (City Council
Resolution No._), and an amended Stage 1 and Stage 2 Development Plan
(Planning Commission Resolution No._), (collectively, together with any
approvals or permits now or hereafter issued with respect to the Project, the
"Alternate Approvals"). Any reference in the remainder of this Agreement to the
"Project" or to the "Hospital" shall mean the development contemplated in the
Alternate Plan that was approved by the Alternate Approvals. In addition, any
reference in this Agreement to the Project shall mean and include the Property,
and any reference in this Agreement to the Property shall mean and include the
Project; and
E. City desires the timely, efficient, orderly and proper development of
the Project; and
F. The Property is located within the Eastern Dublin Specific Plan and
General Plan Amendment area. The Eastern Dublin Specific Plan requires
Developer to enter into this development agreement for the development of the
Project contemplated in the Alternate Approvals, and City has agreed to extend
the term of the Agreement beyond the standard five-year term that the City offers
for development agreements required by the Eastern Dublin Specific Plan in
exchange for the Developer's making a community benefit payment to the City,
as set forth in Exhibit B. A previous development agreement satisfies the
Eastern Dublin Specific Plan's development agreement requirement as to the
Original Approvals. The City Council has found that, among other things, this
Agreement, which applies to the Alternate Approvals, is consistent with the
General Plan and the Eastern Dublin Specific Plan, and has been reviewed and
evaluated in accordance with Chapter 8.56; and
G. The Project is located in the Dublin General Plan Eastern Extended
Planning Area and the Eastern Dublin Specific Plan area, for which a Program
EIR was certified pursuant to the California Environmental Quality Act (CEQA)
(SCH No. 91-103064, Resolution 53-93); the City also approved a Mitigated
Negative Declaration (SCH No. 1996082092) for the Santa Rita Specific Plan
Amendment, of which the Project is a part (collectively, "CEQA Compliance
Documentation"). The City prepared an Initial Study for the Project to determine
Dublin/Triad Dublin Gateway, L.P. Development Agreement
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/61
whether supplemental environmental impacts would occur as a result of the
project beyond or different from those already addressed in the CEQA
Compliance Documentation, and concluded that it did not. Thus, an Addendum
has been prepared in accordance with CEQA Guidelines Sections 15162 and
15164 (City Council Resolution No._).
H. City and Developer have reached agreement, and desire to
express herein a development agreement that will facilitate development of the
Alternate Plan subject to conditions set forth herein; and
I. On ,2007, the City Council of the City of Dublin adopted
Ordinance No. _ -_approving this Agreement. The Ordinance took effect on
, 2007 ("the Approval Date").
NOW, THEREFORE, with reference to the foregoing recitals and in
consideration of the mutual promises, obligations and covenants contained
herein, City and Developer agree as follows:
AGREEMENT
1. Description of Property.
The Property that is the subject of this Agreement is described in Exhibit A
attached hereto.
2. Interest of Developer.
The Developer has a legal or equitable interest in the Property in that it
owns or holds a right to purchase the Property.
3. Relationship of City and Developer.
It is understood that this Agreement is a contract that has been negotiated
and voluntarily entered into by City and Developer, and that the Developer is not
an agent of City. The City and Developer hereby renounce the existence of any
form of joint venture or partnership between them. Nothing contained herein or
in any document executed in connection herewith shall be construed as making
the City and Developer joint venturers or partners.
4. Effective Date and Term.
4.1. Effective Date. The effective date of this Agreement shall be the
date ("the Effective Date") upon which this Agreement is signed by the City.
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4.2. Term. The "Term" of this Agreement shall commence on the
Effective Date and extend ten (10) years thereafter, unless said Term is
otherwise terminated or modified by circumstances set forth in this Agreement.
5. Use of the Property.
5.1. Rioht to Develop. Developer shall have the vested right to develop
and use the Project on the Property in accordance with the terms and conditions
of this Agreement, the Alternate Approvals (as and when issued), and any
amendments to any of them as shall, from time to time, be approved pursuant to
this Agreement.
5.2. Permitted Uses. The permitted uses of the Property, the density
and intensity of use, the maximum height, bulk and size of proposed buildings,
provisions for reservation or dedication of land for public purposes and location
and maintenance of on-site and off-site improvements, location of public utilities
(operated by City) and other terms and conditions of development applicable to
the Property, shall be those set forth in this Agreement, the Alternate Approvals
and any amendments to this Agreement or the Alternate Approvals.
5.3. Additional Conditions. Provisions for the following ("Additional
Conditions") are set forth in Exhibit 8 attached hereto and incorporated herein by
reference.
5.3.1. Subsequent Discretionary Approvals. Conditions, terms,
restrictions, and requirements for subsequent discretionary actions.
(These conditions do not affect Developer's responsibility to obtain all
other land use approvals required by the ordinances of the City of Dublin
to be obtained from other regulatory agencies.) Currently, no future
discretionary approvals (beyond the Alternate Approvals) are needed from
City to develop the Project.
None
5.3.2. Mitiqation Conditions. Additional or modified conditions
agreed upon by the parties in order to eliminate or mitigate adverse
environmental impacts of the Project or otherwise relating to development
of the Project.
See Exhibit B
5.3.3. Phasino. Timinq. Provisions that the Project be constructed
in specified phases, that construction shall commence within a specified
time, and that the Project or any phase thereof be completed within a
specified time.
Dublin/Triad Dublin Gateway, L.P. Development Agreement
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181
See Exhibit B
5.3.4. Financinq Plan. Financial plans which identify necessary
capital improvements such as streets and utilities and sources of funding.
See Exhibit B
5.3.5. Fees, Dedications. Terms relating to payment of fees or
dedication of property.
See Exhibit B
5.3.6. Reimbursement. Terms relating to subsequent
reimbursement over time for financing of necessary public facilities.
See Exhibit B
5.3.7. Miscellaneous. Miscellaneous terms.
See Exhibit B
6. Applicable Rules, Requlations and Official Policies.
6.1. Rules re Permitted Uses. For the Term of this Agreement, the
City's ordinances, resolutions, rules, regulations and official policies governing
the permitted uses of the Property, governing density and intensity of use of the
Property and the maximum height, bulk and size of proposed buildings shall be
those in force and effect on the effective date of this Agreement.
6.2. Rules re Desiqn and Construction. Unless otherwise expressly
provided in paragraph 5 of this Agreement, the ordinances, resolutions, rules,
regulations and official policies governing design, improvement and construction
standards and specifications applicable to the Project shall be those in force and
effect at the time of the applicable discretionary approval, whether the date of
that approval is prior to or after the effective date of this Agreement. Currently,
no future discretionary approvals (beyond the Alternate Approvals) are needed
from City to develop the Project. Ordinances, resolutions, rules, regulations and
official policies governing design, improvement and construction standards and
specifications applicable to public improvements to be constructed by Developer
shall be those in force and effect at the time of the applicable discretionary
approval, whether that date of approval is prior to or after the date of this
Agreement.
6.3. Uniform Codes Applicable. Unless expressly provided in
paragraph 5 of this Agreement, the Project shall be constructed in accordance
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with the provisions of the Uniform Building, Mechanical, Plumbing, Electrical and
Fire Codes and Title 24 of the California Code of Regulations, relating to Building
Standards, in effect at the time of approval of the appropriate building, grading, or
other construction permits for the Project.
7. Subsequently Enacted Rules and Requlations.
7.1. New Rules and Requlations. During the Term of this Agreement,
the City may apply new or modified ordinances, resolutions, rules, regulations
and official policies of the City to the Property which were not in force and effect
on the effective date of this Agreement and which are not in conflict with those
applicable to the Property as set forth in this Agreement if: (a) the application of
such new or modified ordinances, resolutions, rules, regulations or official
policies would not prevent, impose a substantial financial burden on, or materially
delay development of the Property as contemplated by this Agreement and the
Alternate Approvals, and (b) if such ordinances, resolutions, rules, regulations or
official policies have general applicability.
7.2. Approval of Application. Nothing in this Agreement shall prevent
the City from denying or conditionally approving any subsequent land use permit
or authorization for the Project on the basis of such new or modified ordinances,
resolutions, rules, regulations and policies except that such subsequent actions
shall be subject to any conditions, terms, restrictions, and requirements expressly
set forth herein.
7.3. Moratorium Not Applicable. Notwithstanding anything to the
contrary contained herein, in the event an ordinance, resolution or other measure
is enacted, whether by action of City, by initiative, referendum, or otherwise, that
imposes a building moratorium, a limit on the rate of development or a voter-
approval requirement which affects the Project on all or any part of the Property,
such ordinance, resolution or other measure shall not apply to the Project, the
Property, this Agreement or the Alternate Approvals, unless the building
moratorium is imposed as part of a declaration of a local emergency or state of
emergency as defined in Government Code 9 8558.
8. Subsequently Enacted or Revised Fees. Assessments and Taxes.
8.1. Fees. Exactions. Dedications. City and Developer agree that the
fees payable and exactions required in connection with the development of the
Project for purposes of mitigating environmental and other impacts of the Project,
providing infrastructure for the Project and complying with the Eastern Dublin
Specific Plan shall be those set forth in the Alternate Approvals and in this
Agreement (including Exhibit B). The City shall not impose or require payment of
any other fees, dedications of land, or construction of any public improvement or
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facilities, shall not increase or accelerate existing fees, dedications of land or
construction of public improvements, or impose other exactions in connection
with the Alternate Approvals or any subsequent discretionary approval for the
Property, except as set forth in the Alternate Approvals and this Agreement
(including Exhibit B, subparagraph 5.3.5).
8.2. Revised Application Fees. Any existing application, processing and
inspection fees that are revised during the Term of this Agreement shall apply to
the Project provided that (1) such fees have general applicability; (2) the
application of such fees to the Property is prospective only; and (3) the
application of such fees would not prevent, impose a substantial financial burden
on, or materially delay development in accordance with this Agreement.
Developer has no vested right against such revised application, processing and
inspection fees, but Developer does not waive its right to challenge the legality of
any such application, processing and/or inspection fees under the controlling law
then in place.
8.3. New Taxes. Any subsequently enacted city-wide taxes shall apply
to the Project provided that: (1) the application of such taxes to the Property is
prospective; and (2) the application of such taxes would not prevent, impose a
substantial financial burden on, or materially delay development in accordance
with this Agreement. Developer has no vested right against such new taxes, but
Developer does not waive its right to challenge the legality of any such taxes
under the controlling law then in place.
8.4. Assessments. Nothing herein shall be construed to relieve the
Property from assessments levied against it by City pursuant to any statutory
procedure for the assessment of property to pay for infrastructure and/or services
which benefit the Property.
8.5. Vote on Future Assessments and Fees. In the event that any
assessment, fee or charge which is applicable to the Property is subject to Article
XIIID of the Constitution and Developer does not return its ballot, City may, only
after providing reasonable notice to Developer (30 days minimum) of the
assessment, fee or charge, count Developer's ballot as affirmatively voting in
favor of such assessment, fee or charge.
9. Amendment or Cancellation.
9.1. Modification Because of Conflict with State or Federal Laws. In the
event that state or federal laws or regulations enacted after the effective date of
this Agreement prevent or preclude compliance with one or more provisions of
this Agreement or require changes in plans, maps or permits approved by the
City, the parties shall meet and confer in good faith in a reasonable attempt to
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modify this Agreement to comply with such federal or state law or regulation.
Any such amendment or suspension of the Agreement shall be approved by the
City Council in accordance with Chapter 8.56.
9.2. Amendment bv Mutual Consent. This Agreement may be amended
in writing from time to time by mutual consent of the parties hereto and in
accordance with the procedures of state law and Chapter 8.56.
9.3. Insubstantial Amendments. Notwithstanding the provisions of the
preceding subparagraph 9.2, any amendments to this Agreement which do not
relate to (a) the Term of the Agreement as provided in subparagraph 4.2; (b) the
permitted uses of the Property as provided in subparagraph 5.2; (c) provisions for
"significant" reservation or dedication of land as provided in Exhibit B; (d)
conditions, terms, restrictions or requirements for subsequent discretionary
actions; (e) the density or intensity of use of the Project; (f) the maximum height
or size of proposed buildings; or (g) monetary contributions by Developer as
provided in this Agreement, shall not, except to the extent otherwise required by
law, require notice or public hearing before either the Planning Commission or
the City Council before the parties may execute an amendment hereto. City's
Public Works Director shall determine whether a reservation or dedication is
"significant" .
9.4. Cancellation bv Mutual Consent. Except as otherwise permitted
herein, this Agreement may be canceled in whole or in part only by the mutual
consent of the parties or their successors in interest, in accordance with the
provisions of Chapter 8.56. Any fees paid pursuant to subparagraph 5.3 and
Exhibit B of this Agreement prior to the date of cancellation shall be retained by
City.
10. Term of Alternate Approvals.
Notwithstanding Dublin Municipal Code section 8.96.020.D, the term of all
of the Alternate Approvals shall be extended to and until the end of the Term of
this Agreement.
11. Annual Review.
11.1. Review Date. The annual review date for this Agreement shall be
between July 15 and August 15, 2008 and each July 15 to August 15 thereafter.
11.2. Initiation of Review. The City's Community Development Director
shall initiate the annual review, as required under Section 8.56.140 of Chapter
8.56, by giving to Developer thirty (30) days' written notice that the City intends to
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undertake such review. Developer shall provide evidence to the Community
Development Director prior to the hearing on the annual review, as and when
reasonably determined necessary by the Community Development Director, to
demonstrate good faith compliance with the provisions of the Agreement. The
burden of proof by substantial evidence of compliance is upon the Developer.
11.3. Staff Reports. To the extent practical, City shall deposit in the mail
and fax to Developer a copy of all staff reports, and related exhibits concerning
contract performance at least five (5) days prior to any annual review.
11.4. Costs. Costs reasonably incurred by City in connection with the
annual review shall be paid by Developer in accordance with the City's schedule
of fees in effect at the time of review.
12. Default.
12.1. Other Remedies Available. Upon the occurrence of an event of
default, the parties may pursue all other remedies at law or in equity which are
not otherwise provided for in this Agreement or in City's regulations governing
development agreements, expressly including the remedy of specific
performance of this Agreement.
12.2. Notice and Cure. Upon the occurrence of an event of default by
either party, the nondefaulting party shall serve written notice of such default
upon the defaulting party. If the default is not cured by the defaulting party within
thirty (30) days after service of such notice of default, the nondefaulting party
may then commence any legal or equitable action to enforce its rights under this
Agreement; provided, however, that if the default cannot be cured within such
thirty (30) day period, the nondefaulting party shall refrain from any such legal or
equitable action so long as the defaulting party begins to cure such default within
such thirty (30) day period and diligently pursues such cure to completion.
Failure to give notice shall not constitute a waiver of any default.
12.3. No Damaqes Aqainst City. In no event shall damages be awarded
against City upon an event of default or upon termination of this Agreement.
13. Estoppel Certificate.
Either party may, at any time, and from time to time, request written notice
from the other party requesting such party to certify in writing that, (a) this
Agreement is in full force and effect and a binding obligation of the parties,
(b) this Agreement has not been amended or modified either orally or in writing,
or if so amended, identifying the amendments, and (c) to the knowledge of the
certifying party the requesting party is not in default in the performance of its
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obligations under this Agreement, or if in default, to describe therein the nature
and amount of any such defaults. A party receiving a request hereunder shall
execute and return such certificate within thirty (30) days following the receipt
thereof, or such longer period as may reasonably be agreed to by the parties.
City Manager of City shall be authorized to execute any certificate requested by
Developer. Should the party receiving the request not execute and return such
certificate within the applicable period, this shall not be deemed to be a default,
provided that such party shall be deemed to have certified that the statements in
clauses (a) through (c) of this paragraph are true, and any party may rely on such
deemed certification.
14. Mortqaqee Protection; Certain Riqhts of Cure.
14.1. Mortqaqee Protection. This Agreement shall be superior and
senior to any lien placed upon the Property, or any portion thereof after the date
of recording this Agreement, including the lien for any deed of trust or mortgage
("Mortgage"). Notwithstanding the foregoing, no breach hereof shall defeat,
render invalid, diminish or impair the lien of any Mortgage made in good faith and
for value, but all the terms and conditions contained in this Agreement shall be
binding upon and effective against any person or entity, including any deed of
trust beneficiary or mortgagee ("Mortgagee") who acquires title to the Property, or
any portion thereof, by foreclosure, trustee's sale, deed in lieu of foreclosure, or
otherwise.
14.2. Mortqaqee Not Obliqated. Notwithstanding the provisions of
subparagraph 14.1 above, no Mortgagee shall have any obligation or duty under
this Agreement, before or after foreclosure or a deed in lieu of foreclosure, to
construct or complete the construction of improvements, or to guarantee such
construction of improvements, or to guarantee such construction or completion,
or to pay, perform or provide any fee, dedication, improvements or other exaction
or imposition; provided, however, that a Mortgagee shall not be entitled to devote
the Property to any uses or to construct any improvements thereon other than
those uses or improvements provided for or authorized by the Alternate
Approvals or by this Agreement.
14.3. Notice of Default to Mortqaqee and Extension of Riqht to Cure. If
City receives notice from a Mortgagee requesting a copy of any notice of default
given Developer hereunder and specifying the address for service thereof, then
City shall deliver to such Mortgagee, concurrently with service thereon to
Developer, any notice given to Developer with respect to any claim by City that
Developer has committed an event of default. Each Mortgagee shall have the
right during the same period available to Developer to cure or remedy, or to
commence to cure or remedy, the event of default claimed set forth in the City's
notice. City, through its City Manager, may extend the thirty-day cure period
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provided in subparagraph 12.2 for not more than an additional sixty (60) days
upon request of Developer or a Mortgagee.
15. Severabilitv.
The unenforceability, invalidity or illegality of any provisions, covenant,
condition or Term of this Agreement shall not render the other provisions
unenforceable, invalid or illegal.
16. Attornevs' Fees and Costs.
If City or Developer initiates any action at law or in equity to enforce or
interpret the terms and conditions of this Agreement, the prevailing party shall be
entitled to recover reasonable attorneys' fees and costs in addition to any other
relief to which it may otherwise be entitled. If any person or entity not a party to
this Agreement initiates an action at law or in equity to challenge the validity of
any provision of this Agreement or the Alternate Approvals, the parties shall
cooperate in defending such action. Developer shall bear its own costs of
defense as a real party in interest in any such action, and shall reimburse City for
all reasonable court costs and attorneys' fees expended by City in defense of any
such action or other proceeding.
17. Transfers and Assiqnments.
17.1 Developer's Riqht to Assiqn. All of Developer's rights,
interests and obligations hereunder may be transferred, sold or assigned in
conjunction with the transfer, sale, or assignment of the Property subject hereto,
or any portion thereof, at any time during the Term of this Agreement, provided
that no transfer, sale or assignment of Developer's rights, interests and
obligations hereunder shall occur without the prior written notice to City and
approval by the City Manager of City, which approval shall not be unreasonably
withheld or delayed. The City Manager shall consider and decide the matter
within ten (10) working days after Developer's notice is given to City and receipt
by City Manager of all necessary documents, certifications and other information
required by City Manager to decide the matter. In considering the request, the
City Manager shall base the decision upon the proposed assignee's reputation,
experience, financial resources and access to credit and capability to
successfully carry out the development of the Property to completion. The City
Manager's approval shall be for the purposes of: (a) providing notice to City; (b)
assuring that all obligations of Developer are fully allocated as between
Developer and the proposed purchaser, transferee or assignee; and (c) assuring
City that the proposed purchaser, transferee or assignee is capable of performing
Developer's obligations hereunder not withheld by Developer pursuant to
Paragraph 17.3. Notwithstanding the foregoing, provided notice is given as
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specified in Paragraph 23, no City approval shall be required for any transfer,
sale, or assignment of this Agreement to: (1) any entity which either (i) is an
affiliate or subsidiary of Developer or (ii) results from the merger of Developer or
its parent or is the purchaser of all, or substantially all, of the assets of Developer
or its parent; (2) any Mortgagee; or (3) any transferee of a Mortgagee.
17.2 Release Upon Transfer. Upon the transfer, sale, or
assignment of all of Developer's rights, interests and obligations hereunder
pursuant to Paragraph 17.1 of this Agreement, Developer shall be released from
the obligations under this Agreement, with respect to the Property transferred,
sold, or assigned, arising subsequent to the date of City Manager approval of
such transfer, sale, or assignment; provided, however, that if any transferee,
purchaser, or assignee approved by the City Manager expressly assumes all of
the rights, interests and obligations of Developer under this Agreement,
Developer shall be released with respect to all such rights, interests and
assumed obligations. In any event, the transferee, purchaser, or assignee shall
be subject to all the provisions hereof and shall provide all necessary documents,
certifications and other necessary information prior to City Manager approval.
17.3 Developer's Riqht to Retain Specified Riqhts or
Obliqations. Notwithstanding Paragraphs 17.1 and 17.2 and Paragraph 18,
Developer may withhold from a sale, transfer or assignment of this Agreement
certain rights, interests and/or obligations which Developer shall retain, provided
that Developer specifies such rights, interests and/or obligations in a written
document to be appended to this Agreement and recorded with the Alameda
County Recorder prior to the sale, transfer or assignment of the Property.
Developer's purchaser, transferee or assignee shall then have no interest or
obligations for such rights, interests and obligations and this Agreement shall
remain applicable to Developer with respect to such retained rights, interests
and/or obligations.
18. Aqreement Runs with the Land.
All of the provisions, rights, terms, covenants, and obligations contained in
this Agreement shall be binding upon the parties and their respective heirs,
successors and assignees, representatives, lessees, and all other persons
acquiring the Property, or any portion thereof, or any interest therein, whether by
operation of law or in any manner whatsoever. All of the provisions of this
Agreement shall be enforceable as equitable servitudes and shall constitute
covenants running with the land pursuant to applicable laws, including, but not
limited to, Section 1468 of the Civil Code of the State of California. Each
covenant to do, or refrain from doing, some act on the Property hereunder, or
with respect to any owned property, (a) is for the benefit of such properties and is
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a burden upon such properties, (b) runs with such properties, and (c) is binding
upon each party and each successive owner during its ownership of such
properties or any portion thereof, and shall be a benefit to and a burden upon
each party and its property hereunder and each other person succeeding to an
interest in such properties. Developer may assign its benefits and burdens under
this Agreement, subject to the provisions set forth above in paragraph 16 of this
Agreement.
19. Bankruptcy.
The obligations of this Agreement shall not be dischargeable in
bankruptcy.
20. Indemnification.
Developer agrees to indemnify, defend and hold harmless City, and its elected
and appointed councils, boards, commissions, officers, agents, employees, and
representatives from any and all claims, costs (including legal fees and costs)
and liability for any personal injury or property damage which may arise directly
or indirectly as a result of any actions or inactions by the Developer, or any
actions or inactions of Developer's contractors, subcontractors, agents, or
employees in connection with the construction, improvement, operation, or
maintenance of the Project, provided that Developer shall have no
indemnification obligation with respect to negligence or wrongful conduct of City,
its contractors, subcontractors, agents or employees or with respect to the
maintenance, use or condition of any improvement after the time it has been
dedicated to and accepted by the City or another public entity (except as
provided in an improvement agreement or maintenance bond). If City is named
as a party to any legal action, City shall cooperate with Developer, shall appear
in such action and shall not unreasonably withhold approval of a settlement
otherwise acceptable to Developer.
21. Insurance.
21.1. Public Liability and Property Damaqe Insurance. During
construction of the Project, Developer shall maintain in effect a policy of
comprehensive general liability insurance with a per-occurrence combined single
limit of not less than One Million Dollars ($1,000,000.00). The policy so
maintained by Developer shall name the City as an additional insured and shall
include either a severability of interest clause or cross-liability endorsement.
21.2. Workers Compensation Insurance. During construction, Developer
shall maintain Worker's Compensation insurance for all persons employed by
Developer for work at the Project site. Developer shall require each contractor
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and subcontractor similarly to provide Worker's Compensation insurance for its
respective employees. Developer shall indemnify the City for any damage
resulting from Developer's failure to maintain any such insurance.
21.3. Evidence of Insurance. Prior to City Council approval of this
Agreement, Developer shall furnish City satisfactory evidence of the insurance
required in subparagraphs 20.1 and 20.2 and evidence that the carrier is required
to give the City at least fifteen days prior written notice of the cancellation or
reduction in coverage of a policy. The insurance shall extend to the City, its
elective and appointive boards, commissions, officers, agents, employees and
representatives and to Developer performing work on the Project.
22. Sewer and Water.
Developer acknowledges that it must obtain water and sewer permits from
the Dublin San Ramon Services District (UDSRSD") which is another public
agency not within the control of City.
23. Notices.
23.1. All notices required or provided for under this Agreement shall be in
writing. Notices required to be given to City shall be addressed as follows:
City Manager
City of Dublin
100 Civic Plaza
Dublin, CA 94568
FAX No. (925) 833-6651
Notices required to be given to Developer shall be addressed as follows:
Joseph D. Carroll
Triad Partners, Inc.
8001 Irvine Center Drive, Suite 1000
Irvine, CA 92618
FAX No. (949) 679-4242
A party may change address by giving notice in writing to the other party
and thereafter all notices shall be addressed and transmitted to the new address.
Notices shall be deemed given and received upon personal delivery, or if mailed,
upon the expiration of 48 hours after being deposited in the United States Mail.
Notices may also be given by overnight courier which shall be deemed given the
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following day or by facsimile transmission which shall be deemed given upon
verification of receipt.
24. Recitals.
The foregoing Recitals are true and correct and are made a part hereof.
25. Aqreement is Entire Understandinq.
This Agreement constitutes the entire understanding and agreement of the
parties.
26. Exhibits.
The following documents are referred to in this Agreement and are
attached hereto and incorporated herein as though set forth in full:
Exhibit A
Legal Description of Property
Exhibit B
Additional Conditions
Exhibit C
Site Plan of Phase I and II Under the Original Approvals
Exhibit D
Site Plan of Phase I and II Under the Alternate Approvals
27. Counterparts.
This Agreement is executed in two (2) duplicate originals, each of which is
deemed to be an original.
28. Recordation.
City shall record a copy of this Agreement within ten days following
execution by all parties.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement
to be executed as of the date and year first above written.
CITY OF DUBLIN:
By:
Date:
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Janet Lockhart, Mayor
ATTEST:
By: Date:
Fawn Holman, City Clerk
APPROVED AS TO FORM:
Elizabeth H. Silver, City Attorney
TRIAD DUBLIN GATEWAY, L.P.,
a California limited partnership
By: Triad Partners, Inc., a California corporation,
General Partner
By:
Joseph D. Carroll, President
By:
Richard T. Needham, Senior Vice President
(NOTARIZATION ATTACHED)
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Exhibit A
Legal Description of the Property
Parcels 3 and 4, as shown on Parcel Map 8524, filed November 23, 2005, in
book 286 of Parcel Maps, pages 38-41 in the Office of the Recorder of Alameda
County. Assessor Parcel Numbers 986-0016-021 and 986-0016-022,
respectively.
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EXHIBIT B
Additional Conditions
The following Additional Conditions are hereby imposed pursuant to
paragraph 5.3 of this Agreement.
Subparaaraph 5.3.1 -- Subseauent Discretionary Approvals
None.
Subparaaraph 5.3.2 -- Mitiaation Conditions
Subsection a.
Infrastructure Seauencina Proaram
The Infrastructure Sequencing Program for the Project is set forth below.
(i) Roads:
The project-specific roadway improvements (and offers of
dedication) identified in Resolution No. 07-_ of the City Council of the City of
Dublin approving Site Development Review (hereafter "SDR Resolution") shall be
completed by Developer to the satisfaction of the Public Works Director at the
times and in the manner specified in the SDR Resolution unless otherwise
provided below. All such roadway improvements shall be constructed to the
satisfaction and requirements of City's Public Works Director.
(ii) Sewer.
All sanitary sewer improvements to serve the project site (or any
recorded phase of the Project) shall be completed in accordance with DSRSD
requirements.
(iii) Water.
An all weather roadway and an approved hydrant and water supply
system shall be available and in service at the site in accordance with the
tentative map conditions of approval to the satisfaction and requirements of the
City's fire department.
All potable water system components to serve the project site shall
be completed in accordance with the DSRSD requirements.
Recycled water lines shall be installed in accordance with the SDR
Resolution.
(iv) Storm Drainaae.
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(A) The storm drainage systems off-site, as well as on-
site drainage systems for the areas to be occupied, shall be improved consistent
with the Drainage Plan and conditions of approval and to the satisfaction and
requirements of the Dublin Public Works Department applying City's and Zone 7
(Alameda County Flood Control and Water Conservation District, Zone 7)
standards and policies which are in force and effect at the time of issuance of the
permit for the proposed improvements. Pursuant to Alameda County's National
Pollution Discharge Elimination Permit (NPDES) No. CAS0029831 with the
California Regional Water Quality Control Board, all grading, construction, and
development activities within the City of Dublin must comply with the provisions
of the Clean Water Act. Proper erosion control measures must be installed at
development sites within the City during construction, and all activities shall
adhere to Best Management Practices.
(v) Other Utilities (e.a. aas. electricitv. cable televisions.
telephone)
Construction shall be completed by phase prior to issuance of the
first Certificate of Occupancy for any building within that specific phase of
occupancy.
Subsection b.
Miscellaneous
(i) Completion Mav Be Deferred.
Notwithstanding the foregoing, City's Public Works Director may, in
his or her sole discretion and upon receipt of documentation in a form
satisfactory to the Public Works Director that assures completion, allow
'Developer to defer completion of discrete portions of any public improvements for
the Project if the Public Works Director determines that to do so would not
jeopardize the public health, safety or welfare.
Subparaaraph 5.3.3 -- Phasina. Timina
This Agreement contains no requirements that Developer must initiate or
complete development of the Project within any period of time set by City. It is
the intention of this provision that Developer be able to develop the Property in
accordance with its own time schedules and the Alternate Approvals.
Subparaaraph 5.3.4 -- Financina Plan
Developer will install all improvements necessary for the Project at its own
cost (subject to credits for any improvements which qualify for credits as provided
in subparagraph 5.3.6 below).
DublinlTriad Dublin Gateway, L.P. Development Agreement
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33 ~
Other infrastructure necessary to provide sewer, potable water, and
recycled water services to the Project will be made available by the Dublin San
Ramon Services District. Developer will enter into an "Area Wide Facilities
Agreement" with the Dublin San Ramon Services District to pay for the cost of
extending such services to the Project. Such services shall be provided as set
forth in subparagraph 5.3.2(a)(ii) and (iii) above.
Subparaaraph 5.3.5 -- Fees. Dedications
Subsection a.
Traffic Impact Fees.
Developer shall pay the Eastern Dublin Traffic Impact Fee ("TIF")
established by Resolution No. 111-04, including any future amendments to such
fee. Developer will pay such fees, in cash or credits: 1) no later than the time of
issuance of grading/sitework permits for the hospital building and in the amount
of the impact fee in effect at time of grading/sitework permit for the hospital
building; and 2) no later than the time of issuance of building permits for the
parking structure and in the amount of the impact fee in effect at time of building
permit issuance for the parking structure.
Developer further agrees that it will pay eleven percent (11 %) of the
"Section 1/Category 1" portion of the TIF in cash.
Developer also agrees that it will pay twenty-five percent (25%) of the
"Section 2/Category 2" portion of the TIF in cash. If City amends its TIF fee and
as a result the City's outstanding balance due on loans is less than 25% of total
Section 2/Category 2 improvements, the Developer shall pay such reduced
percentage of the "Section 2/Category 2" portion of the TIF in cash.
Subsection b.
Traffic Impact Fee to Reimburse Pleasanton for
Freewav Interchanaes.
Developer shall pay the Eastern Dublin 1-580 Interchange Fee established
by City of Dublin Resolution No. 11-96 as amended by Resolution No. 155-98
and by any subsequent resolution which revises such Fee. Developer will pay
such fee: 1) no later than the time of issuance of grading/sitework permits for the
hospital building and in the amount of the impact fee in effect at time of
grading/sitework permit for the hospital building; and 2) no later than the time of
issuance of building permits for the parking structure and in the amount of the
impact fee in effect at time of building permit issuance for the parking structure.
Subsection c.
Public Facilities Fees.
Developer shall pay a Public Facilities Fee established by City of Dublin
Resolution No. 214-02, including any future amendments to such fee. Developer
will pay such fees: 1) no later than the time of issuance of grading/sitework
DublinlTriad Dublin Gateway, L.P. Development Agreement
For the Dublin Gateway Medical Center Project-EXHIBIT B
61f~
permits for the hospital building and in the amount of the fee in effect at time of
grading/sitework permit for the hospital building; and 2) no later than the time of
issuance of building permits for the parking structure and in the amount of the fee
in effect at time of building permit issuance for the parking structure.
Subsection d.
Noise Mitiaation Fee.
Developer shall pay a Noise Mitigation Fee established by City of Dublin
Resolution No. 33-96, including any future amendments to such fee. Developer
will pay such fees: 1) no later than the time of issuance of grading/sitework
permits for the hospital building and in the amount of the fee in effect at time of
grading/sitework permit for the hospital building; and 2) no later than the time of
issuance of building permits for the parking structure and in the amount of the fee
in effect at time of building permit issuance for the parking structure.
Subsection e.
School Impact Fees.
School impact fees shall be paid by Developer in accordance with
Government Code section 53080 and the agreement between Developer's
predecessor in interest and the Dublin Unified School District regarding payment
of mitigation fees.
Subsection f.
Fire Impact Fees.
Developer shall pay a fire facilities fee established by City of Dublin
Resolution No. 12-03 including any future amendments to such fee. Developer
will pay such fees: 1) no later than the time of issuance of grading/sitework
permits for the hospital building and in the amount of the impact fee in effect at
time of grading/sitework permit for the hospital building; and 2) no later than the
time of issuance of building permits for the parking structure and in the amount of
the impact fee in effect at time of building permit issuance for the parking
structure.
Subsection g.
Tri-Valley Transportation Development Fee.
Developer shall pay the Tri-Valley Transportation Development Fee in the
amount and at the times set forth in City of Dublin Resolution No. 89-98 or any
subsequent resolution which revises such fee. Developer will pay such fees: 1)
no later than the time of issuance of grading/sitework permits for the hospital
building and in the amount of the fee in effect at time of grading/sitework permit
for the hospital building; and 2) no later than the time of issuance of building
permits for the parking structure and in the amount of the fee in effect at time of
building permit issuance for the parking structure.
Dublin/Triad Dublin Gateway, L.P. Development Agreement
For the Dublin Gateway Medical Center Project-EXHIBIT B
35 11Zz/
Subparaaraph 5.3.6 -- Credit
Subsection a.
Traffic Impact Fee Improvements -- Credit
City shall provide a credit to Developer for those improvements described
in the resolution establishing the Eastern Dublin Traffic Impact Fee if such
improvements are constructed by the Developer in their ultimate location. All
aspects of the credit shall be covered by City's Administrative Guidelines for
Eastern Dublin Traffic Impact Fees (Resolution No. 23-99 ("TIF Guidelines")).
Subsection b.
Traffic Impact Fee Riaht-of-Way Dedications --
Credit
City shall provide a credit to Developer for any TIF area right-of-way to be
dedicated by Developer to City which is required for improvements which are
described in the resolution establishing the Eastern Dublin Traffic Impact Fee.
All aspects of the credits shall be governed by the TIF Guidelines.
Subparaaraph 5.3.7 - Miscellaneous
Subsection a.
Community Benefit Payment.
Developer, as a means of ensuring compliance with Section 10.4 and
Policy 10-1 of the Eastern Dublin Specific Plan, has offered to pay to City a
community benefit payment in the amount of two million ninety-three thousand
eight-hundred and seventy-two dollars ($2,093,872.00) (the "Community Benefit
Payment"). The EIR prepared for the Eastern Dublin EIR assumed that project-
generated revenues, including property tax revenues, would be sufficient to pay
for city services necessary to serve new development and determined that no
mitigations were necessary. The Community Benefit Payment is designed to
mitigate the potential impact of the loss of property tax that may result if the
owner or operator of the Hospital were to apply for a property tax exemption and
the Hospital were to be taken off the property tax rolls. Therefore, in addition to
any other fees and payments due and payable, Developer hereby agrees to, at
the time of the issuance of a grading permit to facilitate the construction of the
Hospital under the Alternate Plan, make the Community Benefit Payment, which
shall be non-refundable. If Developer fails to make the Community Benefit
Payment as set forth in this subsection, then Developer agrees that the City may
withhold the issuance of such grading permit. Notwithstanding the foregoing,
Developer shall not be required to make the Community Benefit Payment at the
time of the issuance of a grading permit to facilitate the construction of the
Hospital under the Alternate Plan, if Developer provides evidence satisfactory to
the City Manager that the owner of the Property, when the Hospital commences
operation, will not be eligible for a welfare exemption under Revenue and
Taxation Code section 214. However, if during the Term of this Agreement the
Dublin/Triad Dublin Gateway, L.P. Development Agreement
For the Dublin Gateway Medical Center Project-EXHIBIT B
36 ~
Property becomes exempt from taxation under Revenue and Taxation Code
section 214, then Developer shall be obligated to make the Community Benefit
Payment. Developer, on behalf of itself and its approved successors and
assigns, acknowledges that failure to pay the Community Benefit Payment as
required by this subsection shall constitute grounds for revocation of the Hospital
Conditional Use Permit referenced in Recital D.
Dublin/Triad Dublin Gateway, L.P. Development Agreement
For the Dublin Gateway Medical Center Project-EXHIBIT B
~71
EXHIBIT C
Site Plan of Phase I and II Under the Original Approvals
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Dublin/Triad Dublin Gateway, L.P. Development Agreement
For the Dublin Gateway Medical Center Project-EXHIBIT C
081
EXHIBIT D
Site Plan of Phase I and Phase II Under the Alternate Approvals
DUBLIN BOULEVARD
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Dublin/Triad Dublin Gateway, L.P. Development Agreement
For the Dublin Gateway Medical Center Project-EXHIBIT D
dCJ~ I;).r
Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25. 2005 (P A 04-046)
Amended by Ordinance by the City Council on , 2007 (P A 06-026)
EXHIBIT A
DEVELOPMENT PLAN
General Provisions
This is a Development Plan pursuant to Chapter 8.32 of the Dublin Zoning Ordinance for
the Koll Corporate Center project, located on the south side of Dublin Boulevard, east of
Tassajara Creek, West of Tassajara Road, and north of Interstate 580 (APN 986-0001-001-
10, portion). This Development Plan meets all of the requirements for Stage 1 and Stage 2
review of the project.
This De'o'elopment Plan is also represented by the Tentati'/e Map and Site Development R&'/iew
plans, the Landscape Plans, other plans, exhibits, and vmtten statements contained in the
document dated received October 30, 1998, labeled Exhibit ,^.. 1 to the Resolution approving this
Developmeftt Plan (City Council Resolution ,\'0. 98 ), and on file in the Planning Department.
The Planned Development District allows the flexibility needed to enCOlH'age innovative
development while ensuring that the goals, policies and action programs of the General Plan,
Eastern Dablin Specific Plan, and provisions of Section 8.32 of the Zoning Ordinance are
satisfied.
This Development Plan was subseQuently amended by Planninl! Commission Resolution
04-55 for the Ulferts Center project on AUl!ust 24. 2004. The amendments included the
removal of the hotel desil!nation on Lots 1 and 2 and allowed for the development of retail
commercial uses on the entire property.
This Development Plan was subseQuently amended for the Dublin Gateway Medical Center
project on January 25. 2005. The amendment allowed for massal!e establishments in
conjunction with physical therapy to be a permitted use. rather than conditional use.
consistent with the rel!ulations set forth in the Dublin Zoninl! Ordinance.
This Development Plan was subseQuently amended for the Dublin Gateway Medical Center
Buildinl! 3 Hospital and Garal!e project on rINSERT DATE1. 2007. The amendments
allowed for am alternative development proiect on a portion of Lot 7 of Map 7064
otherwise known as Lots 3 & 4 of Map 8524: an increase in SQuare footal!e on Lot 7 of Map
7064: revisions to the site plan and landscape plan: and. revisions to the development
ret!Ulations.
This Development Plan is also represented by the following:
· Tentative Map 7064 and Site Development Review plans, Landscape plans, and other
plans, exhibits, and written statements contained in the document dated received October
30, 1998, labeled Exhibit A-I to the Ordinance approving this Development Plan (City
lof8
Attachment 3
/.jO 1-
Amended by Resolution 04-55 by the Planning Commission on August 24.2004 (PA 03-064)
Amended bv Resolution 05-06 by the Planning Commission on January 25. 2005 (P A 04-046)
Amended by Ordinance by the City Council on . 2007 (P A 06-026)
Council Ordinance No. 22-98), on file in the Planning Division.
· Site Development Review plans, Landscape plans, and other plans, exhibits and written
statements relating to the proiect approved as part of Planning Commission Resolution
04-55 for the Ulferts Center (P A 03-064), on file in the Plarming Division.
. Tentative Map 8524 and Site Development Review plans, Landscape plans, and other
plans, exhibits and written statements relating to the proiect approved as part of Planning
Commission Resolution 05-06 for the Dublin Gateway Medical Center (P A 04-046), on
file in the Planning Division.
· Site Development Review plans, Landscape plans, and other plans, exhibits and written
statements relating to the proiect approved as part of Ordinance rINSERT ORDINANCE
NO.1 for the Dublin Gateway Medical Center Building 3 Hospital and Garage (PA 06-
026), on file in the Planning Division.
This Planned Development Zoning District, as amended, allows the flexibility needed to
encourage innovative development while ensuring that the goals, policies, and action programs
of the General Plan, Eastern Dublin Specific Plan, and provisions of Section 8.32 of the Zoning
Ordinance are satisfied.
1. Permitted Uses. The following uses are permitted for this "PD / C-2 / C-O" (Planned
Development/General Commercial/Campus Office) Zoning District site.::
a) BarIks & Financial Services;
b) Contractor's Office;
c) Copying & Blueprinting;
d) Eating & Drinking Establishments;
e) Health Services/Clinics;
f) Laboratory;
g) Professional/Administrative Offices;
h) Parking Lot/Garage - Commercial;
i) Retail- General;
j) Retail- Neighborhood;
k) Retail - Service;
I) Day Care of 14 or fewer children;
m) School- trade school, college, university;
n) Similar and related uses as determined by the Director of Community
Development; and,
0) Massage Establishments, in coni unction with physical therapy.
Amended bv PC Reso. 05-06 (01/25/05)
*See "**NOTE" on Paf!e 5 ref!ardinf! uses on Lot 3 of Map 8524.
2of8
.4/1
Amended by Resolution 04-55 by the Planning Commission on August 24, 2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25, 2005 (P A 04-046)
Amended by Ordinance by the City Council on , 2007 (P A 06-026)
2. Conditional Uses.~
a) AutomobileN ehicle Brokerage, Rental;
b) Building Materials Sales;
c) Mini-Storage;
d) Storage of petroleum products for on-site use;
e) Warehousing and distribution;
f) Community Facility;
g) Massage Establishments, in conjunction with a gymnasium/health club, physical
therapy;
Amended bv PC Reso. 05-06 (01/25/05)
h) Day Care Center - 15+ children;
i) Outdoor Mobile Vendor;
j) Outdoor Seating;
k) Temporary Outdoor Sale not related to on-site established business (sidewalk
sale);
I) Caretaker Residence;
m) Hospital/Medical Center;
n) Animal Sales and Services;
0) Auction Yard;
p) AutomobileN ehicle Sales and Service;
q) Bed and Breakfast inn;
r) Car Wash/Detailing;
s) Community Care Facility - Large;
t) Dance Floor;
u) Drive-inlDrive-through business;
v) Hotel/Motel;
w) Plant Nursery;
x) Recreational Facility/Indoor;
y) Recreational Facility/Outdoor;
z) Retail- outdoor storage;
aa) Service Station;
bb) Shopping Center; and,
cc) Similar and related uses as determined by the Director of Community
Development.
*See "**NOTE" on Paf!e 5 ref!ardinf! uses on Lot 3 of Map 8524.
3. Dublin Zoning Ordinance, Applicable Requirements. Except as specifically modified
by the provisions of this PD District Rezone/Development Plan, all applicable general
requirements and procedures of the Dublin Zoning Ordinance shall be applied to the land
3of8
if 2- ':/
Amended by Resolution 04-55 by the Planning Commission on August 24. 2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25. 2005 (P A 04-046)
Amended by Ordinance by the City Council on . 2007 (P A 06-026)
uses designated in this PD District Rezone.
4. Site Plan & Architecture. See attached site and eleyation plans contained in Exhibit .^..
1, De-yelopment Plan. This De','elopment Plan applies to the approximately 37 acre site
ShO'lI11 on this plan on the south side of Dublin Boule'iard, ,;,'est side of Tassajara Road.
This Development Plan applies to the approximately 37-acre site generally located south
of Dublin Boulevard. north of Interstate 580. west of Tassaiara Road and east of John
Monego Court. Any modifications to the project, or development on the future
hotel/retail site (Phase 3), shall be substantially consistent with these plans and of equal
or superior materials and design quality. Development on the future hotel/retail site
(Phase 3) requires approval of Site Development Review by the City of Dublin. The
development of the future hotel/retail site (Phase 3) was modified bv Planninfl
Commission Resolution 04-55 for the Ulferts Center.
The following site plans and elevations are hereby incorporated by reference:
Amended bv Ord. flNSERT ORDINANCE NO.1 (INSERT DATE)
. Ordinance 22-98 for the Koll Dublin Corporate Center. Exhibit A-I (P A 98-047).
. Planning Commission Resolution 04-55 for the Ulferts Center (P A 03-064).
. Planning Commission Resolution 05-06 for the Dublin Gateway Medical Center
(P A 04-046).
. Ordinance [INSERT ORDINANCE NO.1 and Planning Commission Resolution
[INSERT RESOLUTION NO.] for the Dublin Gateway Medical Center Building
3 Hospital and Garage (P A 06-026).
5. Density. The maximum square footage of the proposed development for the parcels
covered under this Development Plan (as shown on the applicable site plan~) is as
follows:
Lot 1, Tract 7064 (FutlHe retail site): 1.6 aeres
7,000 square f~et building area*
Lot 1 & 3. Tract 7064 (Retail site): 1.6 acres & 2.6 acres. respectively
50.530 square feet building area*
Amended bv PC Reso. 04-55 (AUflust 24. 2004)
Lot 2, Tract 7064 (Future Retail site): 1.6 acres
7~000 square feet building area*
Lot 3, Tract 7064 (Future hotel site): 2.6 acres
85,000 square feet building area*
Lot 4, Tract 7064 (4-story office building):
5.53 acres
139,285 square feet building area
4of8
Lf.3 rJ
Amended by Resolution 04-55 by the Planning Commission on August 24.2004 (PA 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25.2005 (PA 04-046)
Amended by Ordinance by the City Council on . 2007 (P A 06-026)
Lot 5, Tract 7064 (4-story office building):
6.67 acres
139,285 square feet building area
Lot 6, Tract 7064 (4-story office building):
6.42 acres
139,285 square feet building area
Lot 7, Tract 7064, (6 story office building):
7.11 acres
178,849 square feet building area
Lot 7 of Tract 7064 has been further divided as follows:
Amended bv CDD Reso. 05-01 (Februarv 28. 2005)
Amended bv PC Reso. 05-06 (Januarv 25.2005)
Amended bv Ord. {INSERT ORD. NO. AND DATEl
Lot 1. Map 8524 (3-storv office building)
3.000 acres
62.300 square feet building area
Lot 2. Map 8524 (3-story office building)
1.009 acres
57.700 square feet building area
Lot 3. Map 8524 (3-story office building) 1.545 acres
58.000 square feet building area OR 168.000 square feet building area**
Lot 4. Map 8524
1.585 acres
4-level parking garage OR 5-level parking garage**
Total Building Area: 178.000 square feet OR 292.000 square feet**
Lot 8, (Park & Ride facility):
1. 74 acres
No building area (parking only)
*NOTE: Densities for Lots 1, 2, and 3 may be combined and re-allocated among
these three lots in any manner within this portion of the project site, but must be
used for General Commercial/Retail uses and a hotel, unless an amendment to this
Planned Development is approved. An amendment to the Planned Development was
approved bv Plannin1! Commission Resolution 04-55 on AU/lust 24. 2004. This
amendment removed the hotel desi1!nation from Lots 1 and 3 and allowed for the
development of retail commercial uses instead.
**NOTE: This Development Plan allows for the development of either: 1) a 3-story.
58.000 square foot medical office building on Lot 3 of Map 8524 and 4-level above
ground parking garage on Lot 4 of Map 8524 OR 2) a 6-story. 168.000 square foot. 100-
bed hospital on Lot 3 of Map 8524 and 5-level parking garage on Lot 4 of Map 8524 with
5of8
YL( ~/
Amended by Resolution 04-55 by the Planning Commission on August 24.2004 CPA 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25.2005 CPA 04-046)
Amended by Ordinance by the City Council on . 2007 CPA 06-026)
one level below ground and 4-levels above ground. At no time shall the 6-story hospital
building on Lot 3 of Map 8524 be utilized for any other use than a hospital without an
amendment to this Development Plan.
6. Phasing Plan. The Corporate Center will be developed in three phases. The First phase
will include the three, four-story office buildings, Park & Ride lot, perimeter landscaping,
on-site entrance roads, and associated site work. The Second phase will be the signature,
six-story office building at the comer of Dublin Boulevard and Tassajara Road (Amended
bv Plannim! Commission Resolution 05-06 on Januarv 25, 2005). The Third phase will
include the Hotel/Retail parcel, which will likely be sold to a separate hotel developer
(Amended bv Planninf! Commission Resolution 04-55 on AUf!ust 24, 2004). Third
phase uses could be constructed after the first phase when a critical mass of on-site
customer support is created. Any hotel/retail uses proposed for the vacant parcel (Lots 1,
2, and 3) must be consistent with the standards established by this Development Plan, and
will require approval of a Site Development Review by the City of Dublin Planning
Commission (Amended bv Planninf! Commission Resolution 04-55 on AUf!ust 24,
2004).
7.
Landscaping Plan.
Development Plan.
reference:
Refer to attachod landscaping plans included in Exhibit .^.. 1,
The following landscaping plans are hereby incorporated by
. Ordinance 22-98 for the Koll Dublin Corporate Center. Exhibit A-I (P A 98-047).
. Pinewave Design and Engineering. 3 sheets. dated received by the Planning
Division on August 17.2004 for the Ulferts Center (PA 03-064). Amended bv
PC Reso. 04-55 (Auf!ust 24, 2004)
. Ware Malcomb. 3 sheets. dated received by the Planning Division on January 11.
2005 for the Dublin Gateway Medical Center (P A 04-046). Amended bv PC
Reso. 05-06 (01/25/05)
. Ware Malcomb and Ridge Landscape Architects. dated received by the Planning
Division on February 26.2007 for the Dublin Gateway Medical Center Building
3 Hospital and Garage (P A 06-026). Amended bv Ord. (Date)
8. Development Standards. Refer to attached Deyelopment Regulations included in
Exhibit A 1, De'.'elopment Plan. The development regulations for the proiect are hereby
incorporated by reference:
. Ordinance 22-98 for the Koll Dublin Corporate Center. Exhibit A-I (P A 98-047).
6of8
4-51
Amended by Resolution 04-55 by the Planning Commission on August 24,2004 (PA 03-064)
Amended bv Resolution 05-06 by the Planning Commission on January 25,2005 (PA 04-046)
Amended by Ordinance by the City Council on , 2007 (P A 06-026)
. Pinewave Design and Engineering dated received by the Planning Division on
August 17,2004 for the Ulferts Center (PA 03-064). Amended bv PC Reso. 04-
55 (Au!!ust 24. 2004)
. Ware Malcomb. dated received by the Planning Division on January 1 L 2005 for
the Dublin Gateway Medical Center (P A 04-046). Amended bv PC Reso. 05-06
(01/25/05)
. Ware Malcomb. dated received by the Planning Division on February 26. 2007
for the Dublin Gateway Medical Center Building 3 Hospital and Garage (P A 06-
026). Amended bv Ord. - (Date)
The development of Lots 3 and 4 of Parcel Map 8524 (formerly a portion of Lot 7 of
Tract Map 7064) shall be peimitted to have:
. A 3-story. 58.000 square foot medical office building (Lot 3) and 4-level above
ground parking garage (Lot 4) approved as part of Planning Commission
Resolution 05-06. OR
. A 6-story. 168.000 square foot. 100-bed hospital building (Lot 3) and 5-level
parking garage (Lot 4) with one level below ground and 4 levels above ground
approved as part of Ordinance - and Planning Commission Resolution - .
The 5-level parking garage approved in coni unction with the 6-story hospital building
may also be constructed with the 3-story medical office building so long as one level of
parking remains underground and only 4-1evels of parking above ground.
NOTE: Any increase in the maximum square footage on Lot 3 of Map 8524. including
the addition of a basement for equipment or any other use. shall require an amendment to
this Development Plan and shall be subiect to review by the Planning Commission with a
recommendation to City Council.
9. General Provisions.
A) The project applicant/developer shall enter into a Development Agreement with the
City of Dublin prior to Final Map approval, which shall contain, but not be limited
to, provisions for financing and timing of on and off-site infrastructure, payment of
traffic, noise and public facilities impact fees, ownership and maintenance of creek
and open space areas, and other provisions deemed necessary by the City to find the
project consistent with the Eastern Dublin Specific Plan.
B) The project applicant/developer shall be required to pay a Public Facilities Fee in the
amounts and at the times set forth in City of Dublin Resolution No. 32-96, adopted
7of8
qC:> ~
Amended by Resolution 04-55 by the Planning Commission on August 24. 2004 (P A 03-064)
Amended by Resolution 05-06 by the Planning Commission on January 25. 2005 (P A 04-046)
Amended by Ordinance by the City Council on . 2007 (P A 06-026)
by the City Council on March 26, 1996, or in the amounts and at the times set forth
in any resolution revising the amount of the Public Facilities Fee.
8of8
4111;;>1" (!J
DUBLIN CITY COUNCIL
PROPOSED HOSPITAL
In considering the proposal to develop a new hospital in Dublin, it is my
sincere hope that the council will consider the following issues in their
deliberations:
1. Hospital Need: Valley Medical Center (137) and San Ramon
Regional Medical Center (123) currently provide for the health
care needs of the greater Tri- Valley area. Should the City Council
evaluate the unmet community health needs? Should the City
Council discuss those needs with the existing local hospitals to
address current perceived health care delivery deficiencies? Has
the Council examined current and future bed and service needs?
2. Hospital Services: The type of hospital proposed will have a
dramatic impact on the City Council's evaluations. If the hospital
has a high outpatient component, higher traffic and parking needs
will be required. If the hospital fills the need for psychiatric and
substance abuse, security and admission severity should be
scrutinized to a higher degree. If the hospital features a single
specialty, the City should consider if its community needs will be
met if}t is an orthopedic or a cardiology specialty service only.
3. Builder Experience: Hospitals are complex, highly regulated
entities. The applicant has indicated that he has no experience in
building a hospital and is unfamiliar with regulations and safety
features inherent in all hospitals. The Council will want some
assurance that an experienced architect and builder will provide the
City with something other than a pretty building which may end up
being dysfunctional and not meet the needs of your constituents.
Attachment 4
lIB '}
cD
. .
", ,.~
4. Facility Ambiguity: The Council should receive unambiguous
plans from the builder since it is unclear from the current drawings
whether the building will be used exclusively for Hospital services
or a combination of Medical Office Building and Hospital
functions. It appears that the builder is seeking approval to
construct a hospital dressed as a Medical Office Building without
the basic components of a working hospital.
5. Facility Deficiencies:
. All single rooms must have a minimum floor capacity of 110
square feet and have sufficient space to accommodate toilet
rooms, wardrobe, entry vestibules and fixed furnishings or
equipment. There is not enough detail in the submitted
drawings to fulfill the Title 24 requirements.
. There is a requirement for one negative pressure isolation
room per 35 beds with separate anteroom, hand washing
fixtures, work counter, stored clean and soiled materials and
an adjoining toilet. It is not clear that the proposed hospital
could accommodate these square foot requirements and no
such required rooms are shown.
. There is no space for surgery, Clinical lab, Radiology,
pharmaceutical and dietetic services required of all hospitals
of 100 beds or more.
. Even the minimum central supply and sterilizing areas are
not designated on the plan. Rooms and spaces must
accommodate soiled work areas, clean work areas, sterilizing
and storage space.
!; q '{)/.
~ (])
. Hospital codes require 20 square feet of general storage per
bed (2,000 sq ft for this 100 bed hospital and specialized
storage for linen, sterile and unsterile supplies must be
provided.
. A host of other requirements focused on patient and
employee safety are not addressed in this plan
6. Facility Circulation and Community Impact Issues.
. Has the City conferred with Fire, Police and Emergency
Services to determine fire and life safety issues.
. The location of the Emergency Department is critical to the
affect on traffic, emergency access and can have a direct
impact on patient lives. What will the noise impact be on the
surrounding neighborhood?
. A great deal of time was spent in the Planning Commission
regarding the location and capacity of the truck dock. The
Council may wish to examine this component more closely
as it appears to be undersized and the number of transports
was underestimated.
. The Council may wish a closer look at how bio-hazardous
waste will be handled and disposed both in terms of location
and access.
. Hospitals require a large amount of power. Will there be a
co-generation plant on site and has emergency power issues
been fully explored.
. Can the existing sewer system handle the additional
capacity?
t '
150 Gf
/f @
"r"" .
THERE ARE ruST TOO MANY UNANSWERED QUESTIONS IN
THIS PROJECT FOR THE CITY COUNCIL TO MOVE FORWARD
AND APPROVE THIS PROJECT AT THIS TIME. I KNOW THE
COUNCIL'S PRIMARY CONCERNS ARE MEETING THE NEEDS
OF THE COMMUNITY AND PROVIDING THE NECESSARY
SAFEGUARDS TO THE CITIZENS OF DUBLIN. THEREFORE, I
URGE THE COUNCIL TONIGHT TO ENGAGE A
KNOWLEDGEABLE HEALTH CARE EXPERT TO ASSIST IN
YOUR DELIBERATIONS AND EV ALUA TION OF THIS PROJECT.
;t;~
51 of /2-7--
STEWART WEINBERG
DAVID A ROSENFELD
WilLIAM A. SOKOL
VINCENT A. HARRiNGTON, JR.
iN, DANIEL BOONE
BLYTHE MICKELSON
BARRY E HINKLE
JAMES RUTKOWSKI.
SANDRA RAE BENSON
CHRISTIAN L. RAtSNER
JAMES J, WESSER
THEODORE FRANKLIN
ANTONIO RUIZ
MATTHEW J, GAUGER
ASHLEY K. IKEDA ..
LINDA BALDWIN JONES
PATRICIA A. DAVIS
ALAN G. CROWLEY
J. FELIX DE LA TORRE
KRISTINA L. HILUvtAN...
ANDREA LAIACONA
EMILY P RICH
WEINBERG, ROGER & ROSENFELD
A PROFESSIONAL CORPORATION
1001 Marina Village Parkway, Suite 200
Alameda, CA 94501-1091
TELEPHONE 510.337.1001
FAX 510.337.1023
LORI K. AQUINO ..
ANNE I. YEN
NICOLE M. PHILLIPS
BROOKE D PIERMAN...
BRUCE A. HARLAND
CONCEPCION E. LOZANO~BATISTA
CAREN P. SENCER
LlNELLE S. MOGADO
MANJARI CHAWLA
KRISTINA M. ZINNEN
PATRICIA M. GATES, Of Counsel
ROBERT A D. PERKINS, Of Counsel
JOHN PLOTZ, Of Counsel
. Also admiRed in Arizona
.. Admitted in Hawaii
... Also admitted in Nevada
May 15,2007
VIA HAND DELIVERY
Mamie R. Nuccio, Associate Planner
City of Dublin
Community Development Department, Planning Division
100 Civic Plaza, Dublin CA 94568
Re: P A 06-026 Dublin Gatewav Medical Center Building 3 Hospital and Garage
Dear Ms. Nuccio:
This letter comments on the Initial Study for the Dublin Gateway Medical Center Building 3
Hospital and Garage ("Project") for which the applicant, Joseph D. Carroll on behalf of the Triad
Dublin Gateway, L.P. ("the Developer") seeks approval of a Planned Development Rezone,
Conditional Use Permit, Site Development Agreement, and an addendum to a prior
Environmental Impact Report ("EIR"). We write on behalf of Service Employees International
Union, United Health Care Workers West ("SEIU-UHW"), a union of over 140,000 California
healthcare workers, pursuant to 14 Cal. Code Regs S 15204.
Although SEIU-UHW recognizes the important role that a new hospital may play in providing
necessary and essential services to the community, there are serious deficiencies in the Initial
Study that need to be addressed by a supplemental EIR before the Project proceeds further. The
Initial Study does not comply with the requirements of the California Environmental Quality Act
("CEQA"), Public Resources Code S 21000 et seq., as explained more fully below. Unless an
adequate EIR is prepared and circulated for public review and comment, the City may not
approve the Project or grant any permits for the Project.
Along with many thousands of members of the general public, SEIU-UHW members live, work,
and pay taxes in the area affected by the Project. They are concerned about sustainable land use
and development in the City of Dublin and the development of health care facilities that embody
sound environmental principles. Poorly planned and environmentally detrimental projects may
jeopardize future jobs by inspiring a backlash against necessary and appropriate expansion of
health care facilities that may employ SEIU-UHW's members. Additionally, SEIU-UHW's
members live in thecommunitiesthatsuffertheimpacts of environmentally detrimental projects.
Union members breathe the same polluted air, encounter the same traffic congestion, endure the
same noise pollution, and suffer the same health impacts as other members of the nearby
community. Furthermore, SEIU-UHW members are also patients and caregivers in the East Bay
LOS ANGELES OFFICE
3435 Wilshire Boulevard. Suite 620
Los Angeles, CA 90010-1907
TEL 213.380.2344 FAX 213.381.1088
SACRAMENTO OFFICE
428 J Street, Suite 520
Sacramento. CA 95814-2341
TEL 916.443.6600 FAX 916.442.0244
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Honolulu, HI 96813-4500
TEL 808.528~8880 FAX 808.528.8881
Attachment 5
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May 15, 2007
Mamie R. Nuecio;- Associate Planner
Page 2
community. SEIU-UHW wishes to ensure that expanded medical facilities are constructed in a
manner that safeguards the health and safety of patients and employees.
Upon review, we have concluded that the Initial Study fails to correctly analyze the need for a
supplemental EIR and, therefore, does not comply with the requirements of CEQA and its
implementing regulations, the CEQA Guidelines, California Code of Regulations, title 14,
S 15000 et seq. ("CEQA Guidelines"). Accordingly, we conclude that action on the project
should be deferred until a supplemental EIR is prepared thatfully complies with CEQA.
Background
In 2005, the Planning Commission approved Phase Two of the Dublin Gateway Medical Center
project providing for the construction of a 3-story, 58,000-square-foot medical office building
and a 4-level parking garage. The Project now proposed by the applicant is a 6-story, 168,000-
square-foot, 100-bed hospital and a 5-1evel parking garage. The proposed resolution appro vi rig
the Project rests on a series of prior environmental reviews of different projects from the one
now proposed: namely, an Eastern Dublin EIR approved in 1994, a Mitigated Negative
Declaration approved in 1996, a State 1 and Stage 2 Development Plan for Koll Dublin
Corporate Center approved in 1998, and a General Plan/Eastern Dublin Specific Plan
Amendment for Dublin Ranch West and a related Supplemental EIR approved in 2005. None of
the prior approvals contemplated the construction of a hospital at the site.
CEQA provides that a subsequent or supplemental EIR may be required if "[s]ubstantial changes
occur with respect to the circumstances under which the project is being undertaken which will
require major revisions in the environmental impact report." Pub. Res. Code S 21166(b). Under
the CEQA regulations, a further EIR is required where major revisions are needed to account for
"new significant environmental effects or a substantial increase in the severity of previously
identified significant effects." CEQA Guidelines, S 15162(a). That is precisely the situation
here.
The Supplemental EIR approved in 2005 reviewed the environmental impacts of the 3-story,
58,000-square-foot medical office building and a 4-leve1 parking garage, referred to above. As
we shall explain below, the near tripling in size of the facility and the proposed change in use
from medical offices to a hospital clearly involve substantial changes that will result in new and
more severe significant environmental impacts than those analyzed in 2005, and hence trigger
the need for a supplemental EIR to analyze the new and more severe environmental impacts of
the expanded and repurposed Project.
The Agenda Statement ("Staff Report") prepared for the Planning Commission meeting of April
24,2007, at which the Planning Commission reviewed the Project, and the Initial Study upon
which the Staff Report is based set forth the City's reasons why no subsequent or supplemental
EIR should be required. These documents and the reasons set forth in them provide an entirely
inadequate basis for the public and the City Council to determine whether the modification to the
project will result in new and more severe environmental impacts that were not adequately
considered in 2005. In fact, the documents demonstrate that such impacts will occur in such
areas as hazardous materials and noise while completely failing to discuss other impacts, such as
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Mamie R. Nuccio, Associate Planner
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the increased emission of air pollutants that will necessarily result from construction of a much
larger facility, the risks oflocating a hospital (rather than a medical office building) in an active
seismic zone on a parcel with a higher than average risk of liquefaction, as well as greatly
increased construction impacts resulting from a much larger project than the one previously
analyzed in an EIR.
CEQA has two basic purposes, neither of which the Initial Study satisfies. First, CEQA is
designed to inform decision-makers and the public about the potential, significant environmental
effects of a project. I "Its purpose is to inform the public and its responsible officials of the .
environmental consequences of their decisions before they are made. Thus, the EIR 'protects not
only the environment but also informed self-government.",2 The EIR has been described as "an
environmental 'alarm bell' whose purpose it is to alert the public and its responsible officials to
environmental changes before they have reached ecological points of no return.,,3
Second, CEQA directs public agencies to avoid or reduce environmental damage when possible
by requiring alternatives or mitigation measures.4 The EIR serves to provide public agencies and
the public in general with information about the effect that a proposed project is likely to have on
the environment and to "identify ways that environmental damage can be avoided or
significantly reduced.,,5 Public agencies must deny approval of a project with significant adverse
effects when feasible alternatives and mitigation measures can substantially lessen such effects. 6
CEQA section 21002 requires agencies to adopt feasible mitigation measures in order to
substantially lessen or avoid otherwise significant adverse environmental impacts of a proposed
project.7 To effectuate this requirement, EIRs must set forth mitigation measures that decision-
makers can adopt at the findings stage of the process.8 For each significant effect, the EIR must
identify specific mitigation measures. Where several potential mitigation measures are available,
each should be discussed separately and the reasons for choosing one over the other should be
stated.9 Mitigation measures should be capable of "avoiding the impact altogether," "minimizing
impacts," "rectifying the impact," or "reducing the impact."1O
Decision-makers must fulfill the state's policy that "public agencies should not approve projects
as proposed if there are feasible alternatives or feasible mitigation measures available which
would substantially lessen the significant environmental effects of such projects. "II Each public
1 CEQA Guidelines ~ 15002(a)(1).
2 Citizens of Goleta Valley v. Board of Supervisors (1990) 52 Cal.3d 553, 564.
3 Berkeley Keep Jets Over the Bay v. Bd. of Port Comm 'rs. (2001) 91 Cal. App. 4th 1344,1354 ("Berkeley Jets");
County ofInyo v. Yorty (1973) 32 Cal.App.3d 795,810.
4 CEQA Guidelines S 15002(a)(2) and (3). See also, Berkeley Jets, supra, 91 Cal. App. 4th, at p. 1354; Citizens of
Goleta Valley v. Board of Supervisors (1990) 52 Cal.3d 553, 564; Laurel Heights Improvement Ass 'n v. Regents of
the University of California (1988) 47 Ca1.3d 376, 400.
5 CEQA Guidelines S 15002(a)(2)
6Sierra Club v. GilroyCity Council(1990) 222 Cal.App.3d 30, 41.
7See also, Pub.Res.Code ~ 21081(a); CEQA Guidelines ~ 15370.
8 CEQA Guidelines S 15126(c).
9 CEQA Guidelines S 15126(c).
JO CEQA Guidelines II. 15370.
J] 1'/
Pub. Res. Code S 21002.
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May 15, 2007
'Mamie R. Nuccio, Associate Planner
Page 4
agency is required to "mitigate or avoid the significant effects on the environment of projects
that it carries out or approves whenever it is feasible to do so.,,12
By denying the existence of significant impacts altogether, the Initial Study fails at disclosure
and leads the City to make inadequate provision for feasible alternatives or feasible mitigation
measures that would substantially lessen the significant environmental effect of the Developer's
proposed hospital.
The Initial Study Fails to Adequately Disclose and Analyze Significant Impacts Relating to
Hazards and Hazardous Materials
As the Initial Study explains, the Project will require the transport, use, and disposal of
hazardous materials such as pharmaceuticals and bio-hazardous waste. After mentioning that the
hospital has a license from the state and must comply with strict regulations for the handling,
storage, and disposal of hazardous materials, the Initial Study breezily concludes that "the
Project will not have any significant impacts as a result of hazards and hazardous materials."
The Initial Study makes two fundamental errors in adopting this errone01:lS conclusion: 1) it
disregards the fact that a 168,000-square-foot hospital will create "new significant environmental
effects or a substantial increase in the severity of previously identified significant effects"
relative to a previously approved 58,000-square-foot medical office building; and 2) it
incorrectly assumes that the existence of state regulations governing hazardous medical waste
eliminate the need for mandatory mitigation measures under CEQA.
First, the hospital with 100 patient beds is obviously going to produce an order of magnitude
more medical waste than an outpatient facility one-third its size. Furthermore, it appears that
medical waste was not analyzed in the previous EIRs. See Initial Study, at p. 44 ("The Eastern
Dublin EIR (Source 12) did not analyze hazards and hazardous materials.") The Initial Study
identifies no prior analysis of medical waste in any other environmental document and, hence,
the public and the City Council must assume that the analysis contained in the Initial Study is all
there is. Even if the much smaller amount of medical waste that would have been produced by a
much smaller outpatient facility had been previously analyzed, the substantial increase in the
severity of this significant effect would require an EIR to analyze the feasibility of all available
mitigation measures. On page 26 of the Initial Study, in response to the question whether the
Project would create a significant hazard to the public through the routine transport, use, or
disposal of hazardous materials, the City erroneously checked the box indicating that the Project
would have "less than significant impact." This is simply wrong. A hospital with an emergency
room is bound to produce significant amounts of medical waste. Even if the Conditions of
Approval contained sufficient mitigation to reduce the hazard from medical waste to
nonsignificance, the City should have checked the box "less than significant with mitigation,"
rather than "less than significant impact." That, however, would have been a red flag that would
undermine the conclusion that the project has "no significant impacts." In reaching its
pollyannish conclusion; the Initial Study sites four "sources": "staff review,"the City of Dublin
General Plan, the City of Dublin Easter Dublin Specific Plan, and the City of Dublin Zoning
Ordinance. See Initial Study, at pp. 26, 33. The public and decision-makers are left to guess
12 Pub. Res. Code * 21002.1 (b)
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May 15, 2007
Mamie R. Nuccio,-Associate Planner
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what possible relevance any of these sources has to the determination that a 100-bed hospital
does not produce significant amounts of hazardous materials.
Second, mere compliance with state regulations does not satisfy CEQA's independent
requirement that all feasible mitigation measures be implemented where a significant
environmental impact would result if no mitigation were required. The City's duty is to require
as a condition of approval that the Applicant undertake all feasible measures to mitigate the
substantially increased significant impact of hazardous medical waste that will be generated by
its proposed hospital. Instead, the City attempts to defer enforcement entirely to the State of
California.13 The State of California enforces the Medical Waste Management Act (Health &
Safety Code, SS 117600-118360); however, conditioning CEQA approval on another agency's
future review of effective mitigation is insufficient to support a determination by the lead agency
that potentially significant impacts will be mitigated. Sundstrom v. County of Mendocino (1988)
202 Cal.App.3d 296. Such avoidance of hard analysis at the approval stage also thwarts the
CEQA requirement that mitigation measures be subject to informed public review. Gentry v.
City of Murrieta, 36 Cal.App.4th 1359, 1393 (1995) ("members of the public and other agencies
must be given an opportunity to review mitigation measures before they are approved").
Furthermore, the substance of the mitigation measures proposed-presumably, compliance with
State regulations-is inadequate as well. The State of Califomia itself recognizes that there are
many feasible measures to reduce hazardous medical waste that are not required by law. In its
2002 publication Hospital Pollution Prevention (P-2) Strategies (attached hereto as Exhibit A),
the California Department of Health Services recommends that all hospitals implement voluntary
P-2 programs in order to provide a safer workplace, reduce lost time due to injuries, lessen
adverse impacts on health and the environment, and reduce the impact on overburdened waste
sites. See Strategies at p. 2. Although the implementation of a P-2 program and many of the
specific recommendations contained in the State's publication are not required by regulations
enforced by the Department of Health Services, they are all mitigation measures that should be
evaluated in an EIR and required, if feasible, to prevent significant impacts from the transport,
use, and disposal of hazardous waste.
The Initial Study Fails to Adequately Disclose and Analyze Significant Impacts Relating to
Noise
The Staff Report asserts that ambulance noise will not be a significant impact on the
environment near the new hospital. This finding of insignificance is not supported by substantial
evidence. The Initial Study reveals the presence of residences approximately 200-feet north of
the Project site. Initial Study, at p. 51.
The City explains that ambulances with sirens blaring will be mostly incoming, rather than
outgoing, as no ambulances will be stored at the site, that there are two other emergency care
facilities in nearby cities, and that the use of sirens is regulated by the California Highway Patrol.
How any of these facts will reduce the noise to nonsignificance is a mystery. Certain facts are
13 This is no more satisfactory than letting an applicant off the hook for analyzing a danger to wildlife because he
holds a hunting license and the state prohibits his taking of endangered species.
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May 15, 2007
Mamie E.. Nuccio, Associate Planner
Page 6
undeniable. Sirens will be used by incoming ambulances. Ambulances which used to go
elsewhere will now come to the site. The City denies the obvious conclusion that significant
noise will be generated by sirens in an effort to avoid a more thorough analysis of feasible
mitigation measures that might be implemented. The City's approach to noise frustrates both of
the major purposes of CEQA: 1) to inform the public and decision-makers of the consequences
of environmental decision before those decisions are made; and 2) to require public agencies to
adopt feasible mitigation measures to lessen the environmental impacts of the projects they
approve. A supplemental EIR is required to examine the impact of noise on local residents and
to require the implementation of feasible mitigation measures.
The Initial Study Fails to Adequately Analyze Significant Impacts on Aesthetics
Under CEQA, it is the state's policy to "[tJake all action necessary to provide the people of this
state with. . . enjoyment of aesthetic, natural, scenic, and historic environmental qualities." Pub.
Res. Code S 21001(b) (emphasis added). Thus, courts have recognized that aesthetic issues "are
properly studied in an EIR to assess the impacts of a project." The Pocket Protectors v. City of
Sacramento, 124 Cal.App.4th 903,937 (2004) (overturning a mitigated negative declaration and
requiring an EIR where proposed project potentially affected street-level aesthetics). "The
opinions of area residents, if based on direct observation, may be relevant as to aesthetic impact
and may constitute substantial evidence in support of a fair argument; no special expertise is
required on this topic." Id. Here, the Staff Report's discussion of aesthetic impacts is cursory,
and apparently met with significant criticism from the Planning Commission that resulted in
significant ad hoc changes. A more systematic approach is needed.
The accepted approach to analyzing visual and aesthetic impacts is as follows
a. Describe the criteria for significance thresholds.
b. Characterize the existing conditions of the project site and the surrounding area by
photograph and description, and select key viewpoints within the area, including scenic
corridors and landscapes.
c. Use photomontages or visual simulations, to illustrate the change in character of the
project site before and after project implementation.
d. Identify feasible mitigation measures and alternatives to reduce or eliminate significant
impacts.
e. Where mitigation measures are proposed, use the simulations to illustrate the change in
character before and after project mitigation measures are imposed (e.g., landscaping at
various stages of growth, setbacks, clustering, reduced scale and height, building color
mQgif19ati()1l)._
An analysis consistent with this approach would allow decision-makers and the public to
evaluate the aesthetic impacts of the project more fully and easily than the sparse and completely
unhelpful narrative currently provided in the Initial Study. The City has failed to take almost all
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May 15, 2007
Mamie R. NucciQ, Associate Planner
Page 7
of these steps, and therefore the conclusion in the Initial Study that all aesthetic impacts will be
less than significant after mitigation is unsupported.
The Initial Study Fails to Adequately Disclose and Analyze Significant Impacts Relating to
Seismicity
Although the Proposed Hospital lies near recognized fault lines and within a liquefaction zone,
the Initial Study fails to analyze alternatives to the Project that would not involve similar risks.
The Association of Bay Area Governments maintains maps on its website that show areas at risk
of liquefaction. (A copy is attached hereto as Exhibit B.) The hospital site is in a yellow zone,
indicating that it is located on land with a heightened risk ofliquefaction in an earthquake. In
response to the question of whether the Project would expose people or structures to potentially
substantial adverse effects, including the risk of loss, injury, or death involving rupture ofa
known earthquake fault, strong seismic ground shaking, or liquefaction, the City simply. checked
the box for "less than significant impact."
This defies common sense and misrepresents the situation to the public and decision-makers.
Indeed, the proposed Statement of Overriding Considerations contains; the more frank, and
contradictory, statement appears that there will be "significant environmental impacts" from
seismic activity: "Even with seismic design, future development of the Dublin Gateway Medical
Center Building 3 Hospital and Garage project could be subject to damage from large
earthquakes, much like the rest of the Eastern Dublin planning area." Statement of Overriding
Considerations, at p. 2.
Apparently, the City believes it can check a box asserting that the project entails no significant
effects in the Initial Study because seismic effects relating to the Project were already analyzed
in 2005 when the project being evaluated was an outpatient medical office building. This would
be an error. The new Project is a 24-hour-per-day hospital with an emergency room and 100
beds. The difference between the effect of a large earthquake on a daytime-use medical office
building compared to the effect on a much larger hospital is obvious. With as many as 100 in-
patients and their caregivers at risk, a hospital clearly requires a more substantial analysis of
seismic issues. An EIR would inform the public and the City Council of the consequences, the
possible alternatives, and the full range of mitigation measures that consultants and the public
might suggest. Merely piggybacking onto the prior review of seismic issues raised by a different
project is an unacceptable dodge of the very specific questions raised by selecting the site for a
hospital.
Furthermore, simply requiring compliance with building codes is not adequate mitigation under
CEQA Obviously, all new construction is required to comply with building codes. CEQA
requires decision-makers to look at a broader range of feasible measures to mitigate significant
impacts. An EIR is needed to discuss whether another location for a new hospital or another use
of the proposed location would be more appropriate fromthe standpoint of public safety. Both
hospitals would undoubtedly be required to meet current building codes, but the environmental
consequences of the locations may nonetheless differ substantially.
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May 15, 2007
Mamie R. Nuccio, Associate Planner
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Furthermore, the procrastinator's methodology of deferring definition and enforcement of
specific mitigation measures to another body at another time is unacceptable under CEQA The
formulation of mitigation measures may not properly be defenoed until after Project approval;
Sundstrom v. Mendocino County, 202 Cal.App.3d 296, 306 (1988) ("The requirement that the
applicant adopt mitigation measures recommended in a future study is in direct conflict with the
guidelines implementing CEQA"). Moreover, CEQA requires that "feasible mitigation measures
will actually be implemented as a condition of development, and not merely adopted and then
neglected or disregarded." Federation of Hillside & Canyon Ass 'ns v. Los Angeles, 83
Cal.App.4th 1252, 1261-62 (2000) (vacating project approval because City failed to make "a
binding commitment to implement the [traffic] mitigation measures. . . in a manner that will
ensure their implementation"). See also Kings County, 221 Cal.App.3d at 729-30 (agency may
not rely on mitigation measures of uncertain efficacy); CEQA Guidelines S 15126.4(a)(2)
(mitigation measures must be fully enforceable through permit conditions, agreements, or other
legally binding instruments).
The Initial Study Fails to Adequately Disclose and Analyze Significant Impacts Relating to
Housing
Under CEQA, any environmental review must analyze the proposed project's potential impacts
related to population, housing, and jobs. Although the Initial Study says little about these issues,
it appears that the Project is expected to generate 525 new jobs. Although some jobs would no
doubt have been created by the much smaller medical office building that was approved in 2005,
many occupants of the medical office building would likely move from existing smaller offices
in nearby communities. The proposed hospital, by contrast, would be a completely new
employer. Thus, it is specious to assume that the effects of building the hospital or the medical
office building on population, housing, and jobs would be the same. The hospital could well
result in double or more the net impact of the medical office building. Accordingly, the Initial
Study's quick conclusion that such impacts are insignificant or already analyzed is unwarranted.
The likelihood is that the proposed hospital will place an increased demand on the local housing
market. The increase in employment and consequent demand for additional housing are
considered to be "economic and social effects" under CEQA, and therefore may not, by
themselves, constitute a significant environmental impact. However, where these impacts
directly lead to significant, physical environmental impacts, they must be considered in an EIR.
(CEQA Guidelines SS 15131, 15064(f) and 15382.) The Project will increase the demand for
additional housing by generating new jobs. This is a potentially significant adverse physical
environmental impact that must be addressed in the EIR. '
The questions posed in CEQA Guidelines Appendix G, Section IX ("Population and Housing")
indicate that direct or indirect growth-inducement caused by new businesses or the creation of a
need for the construction of more housing, can be considered significant environmental impacts.
Because of the-severe lack ofaffotdable hOUSing near Dublin, another criterion would also
appropriately be considered as a threshold of significance: Would the project increase the
demand for affordable housing? Although 75 of the projected employees would be (presumably
high-paid) physicians, the average income of the other 450 employees would be considerably
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May 15, 2007
Mamie R. Nuccio, Associate Planner
Page 9
less. The Project would increase demand for affordable housing in the area, and a detailed
analysis of this impact must be conducted in an EIR.
This Project, by creating new jobs, will also increase the demand for housing and decrease the
availability of rental units in the area. Based on conservative assumptions and excluding
secondary growth inducement, the Project is likely to generate a demand for approximately 250
or more housing units.14 This increase in demand for housing in the area is significant because in
the Dublin area where the Project is located, and in the greater Bay area, there is already a lack
of adequate housing, particularly housing that would be affordable to the new workforce created
by the Project. The Initial Study ignores these impacts. Other potential impacts related to
population and housing include, but are not limited to, the following:
. The project will further reduce the "jobs - housing" balance, resulting in longer
commutes, significant vehicle trips and air quality impacts not disclosed or analyzed in
the Initial Study.
. Cumulative impacts resulting from the increase in population, housing demand and
employment caused by this and other projects. None of these potentially significant
impacts are analyzed in the Initial Study.
. In order to analyze and accurately characterize these population and housing impacts, an
EIR must be prepared which includes, at the very least, the following information:
o Total new housing demand generated by the Project, secondary growth and
cumulative projects;
o The housing affordability range for that new demand;
o The number of new employees of the medical center expected to reside in the
Dublin area;
o Housing available to accommodate total new demand in Dublin and neighboring
communities caused by the Project;
o All potential impacts associated with new housing demand within the region;
o The expected new traffic and transit trips based on where employees will reside
and details of those trips, including geographic range; impacts to road/transit
capacity. This information should be used to revise traffic and transit analyses in
the EIR;
o Additional air quality impacts associated with commute patterns. This information
should be used to revise air quality information in the EIR;
14 This estimate of housing demand is based on an assumption that Y2 of all new full-time employees generated by
the project will require housing in the area.
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Mamie R. Nuccio, Associate Planner
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o The extent to which new employees will need general public assistance (e.g. food
stamps), health care, and housing assistance, among other social services.
In the absence of this information and analysis it is not possible to conclude that impacts related
to population increases, housing and employment will be less than significant.
The Initial Study Fails to Adequately Disclose and Analyze Significant Growth-Inducing
Impacts
CEQA requires that an environmental document include a "detailed statement" setting forth the
growth-inducing impacts of the proposed project. See Public Resources Code S 2ll00(b)(5);
City of Antioch v. City Council of Pittsburg, 187 Cal.App.3d 1325, 1337 (1986) (invalidating
negative declaration that failed to consider growth-inducing impacts). The statement must
"[ d]iscuss the ways in which the proposed project could foster economic growth, or the
construction of additional housing, either directly or indirectly, in the surrounding environment."
CEQA Guidelines S 15l26.2(d). It must also discuss how a project may "encourage and facilitate
other activities that could significantly affect the environment, either individually or .
cumulatively" or "remove obstacles to population growth." id.
The proposed Project, which, if completed, will create hundreds of new jobs, and will thereby
have a significant growth-inducing impact. The Initial Study did not even raise the issue of the
Project's growth-inducing impacts, much less demonstrate that these impacts will be less-than-
significant. An EIR must be prepared that analyzes the growth-inducing impacts of this Project.
The Initial Study Fails to Adequately Disclose and Analyze the Project's Cumulative
Impacts
CEQA unequivocally requires lead agencies to disclose and analyze a project's "cumulative
impacts," defined as "two or more individual effects which, when considered together, are
considerable or which compound or increase other environmental impacts." CEQA Guidelines
S 15355. A lead agency must prepare an EIR if a project's possible impacts, though "individually
limited," prove "cumulatively considerable." S 21 083(b); CEQA Guidelines S 15064(i). The
Initial Study fails to provide any information about other projects planned or proposed in the area
(other than those discussed in prior EIRs from 2005 and earlier) that, along with the proposed
Proj ect, could have potentially significant cumulative impacts.
The proposed Project, when considered in conjunction with new residential, commercial, and
other developments, could have potentially significant environmental impacts, including traffic,
aesthetic, air quality, and land use and planning impacts. Accordingly, the City must prepare an
EIR to analyze these cumulative impacts.
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Mamie R. Nuccio, Associate Planner
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The Initial Study Fails to Disclose and Analyze the Substantial Increase in the Severity of
Construction-Related Impacts Resulting from the Threefold Increase in Project Size
The three-fold increase in the size of the hospital over the previously approved medical office
building will, of course, involve a substantial increase in the significant noise and air quality
impacts of construction. That is sufficient to require a supplemental EIR. Whether construction
occurs over a longer period of time or is greater in intensity, these impacts will be significantly
greater than those analyzed in 2005. Because the description of the project in the Initial Study
does not provide any account of how the hospital will he built-i.e., no construction schedule, no
complement of equipment that will be used, no references to fuels that will be used in the diesel
engines required for construction, etc.-the public and decision-makers are left without any way
to evaluate precisely the highly improbable conclusion that expanding the project to a 168,000-
square- foot hospital will result in no significant impacts during the construction of the hospital.
See Initial Study, Checklist items III(b)-III(d) at p. 24 and XI(d) at p. 29. However, a threefold
increase in overall air pollution seems to be a fair estimate of the consequences of a threefold
increase in the size of the project. The increase in size of the project will result in increased
particulate matter, sulfur dioxides, reactive organic gases, carbon monoxide, and toxic air
contaminants. A supplemental EIR is needed to disclose and analyze these emissions, their
effects, and their possible remediation.
Particulate Matter
Particulate matter during construction is emitted from two sources, engine exhaust and fugitive
dust. The health impacts of particulate matter depend on its size, and the size depends on its
source. Combustion sources, such as vehicle exhaust, predominantly emit particulate matter with
an aerodynamic diameter ofless than or equal to 2.5 micrometers ("PM2.5"), while fugitive dust
consists predominantly of particulate matter less than 10 micrometers ("PMI0").
Historically, health impacts due to particulate matter were regulated through ambient air quality
standards for PMl O. However, a substantial amount of important new research has been
published, documenting new health impacts at much lower concentrations and for different size
fractions of particulate matter than was previously known and reflected in ambient air quality
standards. This new research documents that the inhalation of particulate matter, particularly the
smallest particles, causes a variety of health effects, including premature mortality, aggravation
of respiratory (e.g., cough, shortness of breath, wheezing, bron.chitis, asthma attacks) and
cardiovascular disease, declines in lung function, changes to lung tissues and structure, altered
respiratory defense mechanisms, and cancer, among others. Particulate matter is a non-threshold
pollutant, which means that there is some possibility of an adverse health impact at any
concentration.ls This new information led the U.S. Environmental Protection Agency ("U.S.
EPA") and the State of California to adopt new ambient air quality standards for PM2.5. These
standards are notsubsetsofthe old PMIOstandards, but new standards for a separate pollutant
with distinguishable impacts.
15 See American Trucking v. EPA: Unjustified Revival of the Nondelegation Doctrine, 23-SPG Environs Envtl. L &
Pol'y J. 17,26.
o 2-~, I?-
May 15, 2007
Mamie R. Nuccio, Associate Planner
Page 12
The new annual PM2.5 standard of 12 Jlg/m3 was adopted by the California Air Resources Board
("CARB") on June 20, 2002 and became effective on July 5, 2003. At the same time, California
lowered its annual PMlO standard from 30 Jlg/m2 to 20 Jlg/m3. (CARB 0910516.)
Sulfur Dioxides
A supplemental EIR is also required to address that increased S02 emissions from Project
construction and to discuss the resulting air quality impacts. S02 causes a wide variety of health
and environmental impacts because of the way it reacts with other substances in the air. irritates
the respiratory system of animals and humans and injures many plant species as well. S02 reacts
with other chemicals in the air to form tiny sulfate particles. When these are breathed, they
gather in the lungs and are associated with increased respiratory symptom and disease.
Particularly sensitive groups include people with asthma who are active outdoors and children,
the elderly, and people with heart or lung disease. Haze produced by sulfate particles is a major
cause of reduced visibility. S02 combines with other compounds to produce acid rain which
damages plants and buildings downwind.
Reactive Organic Gases
A supplemental EIR is also required to analyze the increased emission of Reactive Organic
Gases (ROGs) caused by the expansion of the project. ROGs will be emitted with combustion
exhaust from construction equipment, haul trucks, and construction worker vehicles. ROGs are
also released in large quantities from architectural coatings. (Id.)
ROGs, also known as volatile organic compounds (VOCs), can cause cancer, birth defects, nerve
damage and kidney and heart disease. ROGs also pose a danger as ozone precursors. Ozone, the
principal element of smog, is a secondary pollutant produced when two precursor air pollutants
- ROGs and nitrogen oxides ("NOx") - react in sunlight: 17 ROGs and NOx are emitted by a
variety of sources, including cars, trucks, industrial facilities, petroleum-based solvents, and
diesel engines.
The human health and associated societal costs from ozone pollution are extreme. In proposing a
new rulemaking limiting emissions of NO x from certain diesel engines, EP A summarized the
effects of ozone on public health:
"A large body of evidence shows that ozone can cause harmful respiratory
effects, including chest pain, coughing and shortness of breath, which.
affect people with compromised respiratory systems most severely. When
inhaled, ozone can cause acute respiratory problems; aggravate asthma;
cause significant temporary decreases in lung function of 15 to over 20
percent in some healthy adults; cause inflammation of lung tissue, produce
changes in lung tissue and structure; may increase hospital admissions and
16 California Air Resources Board, Review of the Ambient Air Quality Standards for Particulate Matter and Sulfates,
http://www.arb.ca.gov/research/aaqs/std-rs/std-rs.htm. accessed September 8, 2005.
17 American Petroleum Institute v. Costle, 665 F.2d 1176, 1181 (D.C. Cir. 1981).
(, 31 I 2-- 1.--
May 15,2007
Mamie R. Nuccio, Associate Planner
Page 13
emergency room visits; and impair the body's immune sy,stem defenses,
making people more susceptible to respiratory illnesses.,,18
Moreover, ozone is not an equal opportunity pollutant, striking hardest the most vulnerable
segments of our population: children, the elderly, and people with respiratory ailments. (Id.)
Children are at greater risk because their lung capacity is still developing, because they spend
significantly more time outdoors than adults - especially in the summertime when ozone levels
are the highest, and because they are generally engaged in relatively intense physical activity that
causes them to breathe more ozone pollution. (!d.)
Ozone has severe impacts on millions of Americans with asthma. While it is as yet unclear
whether smog actually causes asthma, there is no doubt that it exacerbates the condition.19
Moreover, as EP A observes, the impacts of ozone on "asthmatics are of special concern
particularly in light of the growing asthma problem in the United States and the increased rates
of asthma-related mortality and hospitalizations, especially in children in general and black
children in particular."zo In fact:
"[A]sthma is one of the most common and costly diseases in the United
States. ... Today, more than 5 percent of the US population has asthma
[and] [o]n average 15 people died every day from asthma in 1995. . .. In
1998, the cost of asthma to the U.S. economy was estimated to be $11.3
billion, with hospitalizations accounting for the largest single portion of
the costS."ZI
The health and societal costs of asthma are wreaking havoc in California. There are currently 2.2
million Californians suffering from asthma.22 In 1997 alone, nearly 56,413 residents, including
16,705 children, required hospitalization because their asthma attacks were so severe.
Shockingly, asthma is now the leading cause of hospital admissions of young children in
Califomia.z3 Asthma hospitalizations reflect massive human suffering and also impose a huge
financial drain on the state's health care system. The most recent data indicate that the statewide
financial cost of these hospitalizations was nearly $350,000,000, with nearly a third of the bill
paid by the State Medi-Cal program.24
A supplemental EIR is required to analyze increased emissions of ROGs in view of their key role
as ozone precursors.
]866 Fed. Reg. 5002, 5012 (Jan. 18,2001).
19 See 66 Fed. Reg. 5002,5012 (Jan. 18,2001) (EPA points to "strong and convincing evidence that exposure to
ozone is associated with exacerbation of asthma-related symptoms"). .
2062 Fed. Reg. at 38864.
"j
- 66 Fed. Reg. at 5012.
22 California Department of Health Services, California County Asthma Hospitalization Chart Book, August 1,
2000.
23 Id., at 1.
24 Id., at 4.
GLf Pi J2f-,
May 15,2007
Mamie R. Nuccio, Associate Planner
Page 14
Carbon Monoxide
The supplemental EIR must also analyze increased carbon monoxide (CO) emissions analysis
during the construction phase of the Project. CO is a colorless, odorless gas that is formed when
carbon in fuel is not burned completely. Although motor vehicles contribute about 56 percent of
all CO emissions nationwide; other non-road engines and vehicles (such as construction
equipment) contribute about 22 percent of all CO emissions nationwide.
Toxic Air Contaminants ("TACs") From Diesel-Fueled Equipment
A supplemental EIR must analyze combustion emissions of toxic air contaminants ("T ACs")
from diesel-fueled equipment for both the construction and operational phases of the Project.
These unanalyzed emissions are significant and require a health assessment.
CONCLUSION
Prior to granting approval of the Project, the City is required to make its own findings as to the
adequacy of the environmental review on which the approval is based. These finding must
represent the City's own, independent judgment, and must be based on the analysis conducted in
the Initial Study and any public comments submitted to the City.
The Draft Resolution, prepared for adoption by the City Council, states that "an Initial Study has
been prepared for the Project and a determination has been made that the proposed Project will
not have a significant effect on the environment." The City Council cannot make this
determination based on the tangled and incomplete record before it.
For the reasons set forth above, the only prudent course for the City is to defer action on the
Dublin Gateway Medical Center Building 3 Hospital and Garage until a supplemental EIR is
prepared that fully complies with CEQA The Initial Study is lacking in many essentials and
cannot provide a legally defensible basis for approval of the project.
Sincerely,
/fCQ..-. ~UL:-
Theodore Franklin
TF/x
Enclosures
01>51/2--'2/
EXHIBIT A
0G~}?~~.
b7112-l-
Hospital Pollution Prevention (P-2)
Strategies
California
Department of
Health Services
Gray Davis, Governor
STATE OF CALIFORNIA
Diana M. Bonta, R.N. Dr.P.H., Director
DEPARTMENT OF HEALTH SERVICES
Grantland Johnson, Secretary
HEALTH AND HUMAN SERVICES AGENCY
09- oP J,2)'/
--f
Hospital Pollution Prevention (P-2) Strategies
December 2002
Prepared by:
California Department of Health Services
Environmental Management Branch
Jack McGurk, Chief
and
Darice Bailey
Cindy Garcia
Steve Kubo
Mike Schott
Additional copies of this publication can be obtained through requests made by
mail, fax, or phone to:
Environmental Management Branch
Medical Waste Management Program
P.O. Box 942732 MS 396
Sacramento, CA 94234-7320
Phone: (916) 327-6904
FAX: (916) 323-9869
Or viathelnternet at:
http://www.dhs.ca.gov/MedicaIWaste
Co OJ C9;f I 2-- ~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
TABLE OF CONTENTS
CHAPTER I .................................................................................. ........................1
INTRODUCTION.... .......... ................... .......... .................... ........ ...........................1
CHAPTER II ........................................... ..............................................................3
P-2 PROGRAM PLANNING AND IMPLEMENTATION .......................................3
PLANNING P-2 PROGRAMS........................................................................... 3
UNDERSTANDING THE WASTE SYSTEMS WITHIN THE FACILlTY............4
RECOGNIZING THE NEED TO REDUCE WASTES .......................................5
P-2 PROGRAM IMPLEMENTATION......... ............... .................. ............ .......... 7
CHAPTER III .. ................................................... ............... .................. ................... 9
HAZARDOUS WASTE MINIMIZATION............................................................... 9
HOSPITAL EQUIPMENT AND DEVICES CONTAINING MERCURY..............9
Sphygmomanometers................,................................................................. 9
Baumanometer@ Safety Devices. .......... ................................................10
Sphygmomanometer Service Kit............................................................ 12
Esophageal Dilators (Bougies) and Feeding Tubes ...................................13
Gastro/Esophageal Tubes Containing Mercury .......................................... 13
Barometers in Respiratory Therapy......... .......... .................. ....................... 14
Thermometers...................... ........................ .............................................. 14
Intraocular Pressure Devices.............................................................. .... ...16
B-5 Fixative............. ............................ .......................................................17
Mercury-Free Cleaning Products..................... ......... ............................ ...... 17
MERCURY CONCERNS IN HOSPITAL OPERATIONS ................................17
Mercury-Containing Devices In Medical Waste or Sharps Containers ........18
Mercury Collection Areas.............................................. .............................18
Transporting Mercury Devices................. ..................... ....... ...............,. ......18
Spill Clean Up........ .......... ........................................................................... 19
Spill Clean Up Kit .......................................................................................19
Keeping Mercury Out of the Hospital..........................................................20
Mercury Assessment................................................................... ...............20
Plumbing Traps....................................... .......... ........ .... .......................... ... 20
Fluorescent Lighting... ......................................................................... .......20
Electrical Supplies................................................................ ......................21
Calculations and Quantification .......................................... ................. ....... 21
Business Plan............................................................................................. 22
FOLLOW UP .................................................................................................. 22
HAZARDOUS MATERIALS MINIMIZATION ....................................... ...........23
State of California
Department of Health Services
December 2002
10 ~ ,tZ--v
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
CHAPTER IV............ ........ .... ..... .......... ......... ......... .... ................ ............. ..... .......27
SOLID WASTE MINIMIZATION ....... ............ ............... ..... ......... ........................ .27
PERFORMING THE SOLID WASTE AUDIT .............................:....................28
SUCCESSFUL SOLID WASTE REDUCTION STRATEGIES ........................28
CHAPTER V ....................................................................................................... 32
MEDICAL WASTE MINIMIZATION............ ......... ....... ......... .................... ...........32
MEDICAL WASTE MANAGEMENT LEADERSHIP........................................32
SUCCESS THROUGH STAFF PROCESS OWNERSHIP .............................33
DEVELOPING STRATEGIES TO MINIMIZE MEDICAL WASTES................. 33
MEDICAL WASTE MINIMIZATION PLANNING .............................................35
MEDICAL WASTE MINIMIZATION ASSESSMENT .......................................35
MEDICAL WASTE MINIMIZATION IMPLEMENTATION................................35
SUCCESSFUL MEDICAL WASTE REDUCTION STRATEGIES ...................36
State of California
Department of Health Services
December 2002
i1i
1/ 1 } 2-- 7.--
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
CHAPTER I
INTRODUCTION
This document was prepared in partial fulfillment of a pollution prevention (P-2) grant
received by the Environmental Management Branch (EMB) within the California
Department of Health Services from Region IX of the U.S. Environmental Protection
Agency (U.S. EPA). EMB implemented the P-2 Project in six participating Bay Area
hospitals to reduce their medical and solid waste streams and to eliminate mercury
from their wastes. Additional hospitals have joined with EMB to implement P-2
program activities. The lessons learned from the participating hospitals have been
used in developing this document.
EMB and the California Healthcare Association partnered in developing the Self-
Assessment Manual for Proper Management of Medical Waste that was printed
during 1998. As part of the P-2 Project, EMB published A Guide to Mercury
Assessment and Elimination in Healthcare Facilities during 2000. Information from
those two documents, as well as information from the solid and medical waste
reports that were prepared for the participating facilities, have been used in creating
this document.
A systems approach has been undertaken through the P-2 Project, as it is
recognized that waste generation is an integral part of the healthcare system.
Patients come into the hospital, services are provided, and wastes are generated in
the process. To achieve desired outcomes the systems within a facility must be
working harmoniously and not against each other. Although this sounds very
straight forward, it is surprising how many systems are not aligned and actually are
working against each other. The late quality guru W. Edwards Deming indicated that
we must optimize the operations of the interdependent components within an
organization to accomplish the aim of the system.1 To ensure that wastes are
handled, containerized, and stored properly, the environmental services staff within
the hospital must work across professional boundaries with doctors, nurses,
laboratory staff, and other generators. Unanticipated fiscal benefits were realized
from the P-2 Project when systems were studied and improved. Systems
improvement has become an area of focus within the P-2 process.
Additional benefits can accrue to the hospital when P-2 and systems improvement
activities are implemented. Waste disposal costs can be lowered as waste volumes
are reduced or eliminated. Income can be generated through some recycling efforts.
The hospital can enhance its image through the following P-2 and systems
improvement outcomes:
· Providing a safer workplace
o Reducing workers' compensation claims
1 berning, w. Edwards, The New Economics For Industry, Government, Education,
Massachusetts Institute of Technology, 1993, page 98.
State of California
Department of Health Services
December 2002
72-- 112-~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
o Reducing lost time to injuries
o Improving worker satisfaction because the hospital has reduced
causes of injuries
. Enhancing regulatory compliance
. Lessening adverse impacts on health and the environment
. Reducing the impact on overburdened waste sites
. Gaining recognition as a "good neighbor" to the community
. Gaining recognition as an industry leader in pollution prevention
. Increasing morale and pride as a member of an organization focused on P-2
These potential benefits should be sufficient to stimulate more hospital
administrators to provide the leadership for their facilities to move into P-2 and
systems improvement activities. This document provides the required information to
institute a P-2 and systems improvement program in the hospital setting.
State of California
Department of Health Services
December 2002
2
73 ~ /2-~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
CHAPTER II
P-2 PROGRAM PLANNING AND IMPLEMENTATION
PLANNING P-2 PROGRAMS
If a P-2 program is to be successful within a hospital, top administrators within that
facility must support it. The P-2 Project required written approval by the hospital
administrator for the facility before that hospital could be a participant. The
administrator also designated a staff member that would be the point person for the
P-2 Project within the hospital. The approval form also indicated that staff would be
given time to participate in P-2 activities. This process helped to ensure that the P-2
Project would be initiated within the facility.
The P-2 Project staff worked with the designated coordinators within each hospital
facility. The P-2 coordinator was responsible for gaining project support from others
throughout the hospital to join and become part of the P-2 team. It was found to be
beneficial to create a P-2 team with representation from the various disciplines
across the facility such as:
. Environmental Services/Housekeeping
. Infection Control Nursing
. Health and Safety/Hazardous Materials
· Risk Management
. Purchasing
Partnering with suppliers and regulators can also be beneficial and help ensure the
success of the P-2 program. Suppliers can bring the latest technologies to the
facility and can assist in developing cost-efficiencies in the products purchased by
the hospital. Some suppliers can provide crucial services to the hospital to
implement environmental improvements. For example, some suppliers will take
mercury-containing sphygmomanometers from the hospital for recycling when
mercury-free aneroid sphygmomanometers are purchased from them. In addition to
selling products, suppliers often are able to provide essential training in the proper
use of the equipment and supplies they sell.
EMS's P-2 Project staff and the participating hospitals utilized a "safe harbor"
arrangement that relieved anxiety of hospital staff that the regulatory agency might
document violations while at their facility. EMS committed not to document
violations at the facility while they were present conducting P-2 Project activities;
these findings instead were discussed with the hospital staff and corrective actions
implemented. The safe harbor did not apply during regular medical waste
inspections or in response to complaintsthCit untreat~(:trn~c:iiGal\IIJCi~te hag been
improperly handled and/or disposed. EMS first used the safe harbor concept when it
developed the self-assessment manual. '
State of California
Department of Health Services
December 2002
3
7Lf<?/I2-Y
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Figure 1 A soap dispenser
supplier gives a presentation to
hospital representatives. (Pollution
Prevention Project Photograph)
Consultation and collaboration between the regulatory agency and the generator
develops the best means for quickly solving problems. In its January 26, 1996
edition, the Los Angeles Daily Journal described this self-assessment project as the
"Most promising new program for 1996.,,2
UNDERSTANDING THE WASTE SYSTEMS WITHIN THE FACILITY
To successfully reduce or minimize waste generation one must first understand why
the wastes were created; where they arise; the special waste handling processes for
worker and public safety; regulatory compliance governing the handling of the waste
stream; and the varying costs of handling, treating, and disposing of these wastes.
The following represent the six major waste streams generated within hospitals:
1. Liquid wastes
2. Solid wastes.
3. Hazardous wastes
4. Radioactive wastes
5. Air emissions
6. Medical wastes
Each of these waste streams is governed by a specialized set of laws and
regulations to ensure worker and public safety, as well as environmental protection.
Some of these wastes may be found in different physical forms such as the liquid
and solid states of medical wastes.
Wastes are unwanted items that are generated by the various systems and
processes in operation within the hospital. The treatment technologies and disposal
costs vary from one waste stream to another, making it fiscally prudent to handle the
waste in the cheapest waste category legally allowed;
2 Hsiao, Peter, "Prize Policies-Evaluating Environmental Amnesty Programs," Los Angeles Daily
Journal, January 26,1996.
State of California
Department of Health Services
December 2002
4
rlS ~ ) 2-2-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
RECOGNIZING THE NEED TO REDUCE WASTES
The handling, storage, transportation, treatment, and disposal of wastes are a cost
of doing business for the hospital. Improper management of the various regulated
waste streams can result in additional expenditures for failing to comply with the
laws and regulations governing these wastes. Segregation of the wastes requires
employees to identify hazards associated with the various wastes. If employees are
unable to recognize the various waste streams they not only increase the cost of
disposal but also increase the likelihood of personal or public injury. Added to this
situation is the unknown cost created by bad publicity and possible enforcement
actions for failing to properly handle the waste stream.
Regulators classify mixed waste and specify the required manner of its disposal
according to the most highly regulated component in the mix. Thus, solid waste
mixed with medical waste is classified as medical waste and hospitals must dispose
of it as such. This may increase the cost of disposal by at least 20 times over the
cost if the waste streams had not been commingled.
Management and staff must be committed to waste minimization in order to
successfully implement waste reduction within the hospital setting. Management
must communicate the need for waste minimization in a manner that inspires staff to
implement positive actions towards waste reduction. This can be achieved by
publishing a "waste minimization strategy" to guide these efforts within the facility.
State of California
Department of Health Services
5
Figure 2 Pollution
prevention display at a
hospital's "Earth Day" Fair.
(Pollution Prevention Project
Photograph)
December 2002
,10 ~/~,
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
The strategy should state the goal of the waste minimization program and identify
new policies and directives for handling and discarding the various waste streams.
Waste reduction comprises any practice that reduces the amount of waste
generated. At the heart of waste minimization are activities that:
. Prevent waste generation,
. Reduce waste generation,
· Reuse waste that has been generated, and
. Recycle waste.
An additional component is purchasing recycled-content products or developing new
products that utilize recycled materials. This assists in perpetuating the recycling
process.
Technology is assisting hospitals in preventing the generation of some wastes. The
change to electronic data storage for patient records is reducing the generation of
paper wastes while speeding access to the records.
Kaiser hospitals use plastic totes for shipping supplies from their central warehouse
to hospitals to reduce the need for cardboard containers. Supply trucks pick up the
empty plastic totes from the back docks of the hospitals on a scheduled basis for
return to the central warehouse for reuse.
Figure 3 The Bio Elite red bag contains 30 percent
recycled plastics and weighs less than standard red bags.
(Pollution Prevention Project Photograph)
State of California
Department of Health Services
Hospitals are composting yard and food
wastes and using the resultant mulch as a soil
amendment. Hospitals are also baling
cardboard wastes for reuse.
The Bio Elite Bag Company in Southern
California is manufacturing red bags for
medical wastes, as well as laundry and solid
waste bags, using at least 30 percent recycled
plastics. These high-density bags also weigh
less and are stronger than the traditional low-
density bags that have been in use, thus
offering additional savings in waste reduction
and costly spill cleanups.
December 2002
6
/7 112--v
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
P-2 PROGRAM IMPLEMENTATION
To be successful, waste minimization efforts must begin with formulation of
implementation strategies. The strategies should describe how the hospital's waste
minimization goal would be achieved. Formal strategies contain the following
elements:
. Goals to be achieved,
. Policies that guide or limit action regarding those goals, and
. Action sequences or programs that strive to accomplish the goals.3
The waste minimization strategy should be formally approved by top management
within the hospital as a commitment to the program. Top management should next
assign responsibility for the program to an individual, department head, team, or
council. The individual or team responsible for implementing and coordinating the
waste minimization program must be empowered by management to work across
organizational boundaries in carrying out the program. When management
announces the waste minimization strategy and assignment of responsibility they
should include an expectation of cooperation from every operational unit and
individual throughout the hospital.
Once management has announced the waste minimization strategy and assigned
responsibility for implementation, the next task is to gather data as to the current
waste streams being generated within the hospital. These data should include the
quantities of waste being generated for each of the waste streams and the costs
associated with handling and treatment of these wastes. This information can be
utilized to help plan where to initiate waste minimization strategies, as well as to
document the status of the wastes being generated at the start of the waste
minimization project. These data will also provide the baseline from which to
demonstrate the amount of change that has been achieved from implementation
strategies. The ability to document success requires that accurate initial
assessment data have been gathered.
The status of waste minimization projects and results achieved from these activities
should be communicated throughout the facility. Several hospitals have included
information about their P-2 activities and achievements for waste minimization in
staff and patient newsletters. Charts showing achievements should be prominently
displayed throughout the hospital to encourage further actions in waste minimization.
Success should be shared with the surrounding community to demonstrate that the
hospital is a good environmental steward.
3 Dean, James W., Jr. and James R. Evans, Total Quality Management, Organization, and
Strategy, West Publishing Company, 1994, page 260.
State of Califomia
Department of Health Services
December 2002
7
7& ~~ Jz-~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
14000
12000
10000
Cl
:J:
-
0 8000
/II
E
e
C) 6000
4000
2000
0
Mercury Reduction
11953
8594
1155 1155
Figure 4 Waste being weighed
and the results entered into a
computer for tracking to the point of
generation. (Pollution Prevention
Project Photograph)
1015
GI Devices
Lights
0'
120
o
o
o
Non-clinical
Thermometer
Sphygs
! .before .after (1 year)
Figure 5 Chart showing "before" and "after" mercury assessment and removal results from a hospital. (Pollution Prevention Project
Photograph
State of California
Department of Health Services
8
December 2002
71 1 )~2-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
CHAPTER III
HAZARDOUS WASTE MINIMIZATION
HOSPITAL EQUIPMENT AND DEVICES CONTAINING MERCURY
Sphygmomanometers
The sphygmomanometer that traditionally has been used in hospitals to monitor
blood pressure contains mercury. Until recently, this was the only accurate
sphygmomanometer on the market. Although technical developments have given
the mercury-free aneroid sphygmomanometers an accuracy rating similar to the
mercury units, it is often difficult to convince some practitioners to change.
Arguments are made that aneroid sphygmomanometers add to the burden of
hospital maintenance staff because of the need for periodic calibration. However,
mercury sphygmomanometers also need periodic maintenance. The expense and
time of managing maintenance, spills, and disposal of mercury
sphygmomanometers can outweigh the time needed for calibrating the aneroid units.
Many hospitals are replacing mercury sphygmomanometers and have found that
companies that manufacture aneroid sphygmomanometers have policies that make
replacement more economically feasible. These companies may take back and
recycle mercury units on a one-for-one basis when their aneroid units are
purchased. The purchasing department of a hospital can negotiate with these
companies to get the best price for the number of mercury sphygmomanometers
they want to replace and not to be burdened with additional mercury disposal costs.
State of California
Department of Health Services
9
Figure 6 Bedside mercury
sphygmomanometer commonly
found in hospitals. (Pollution
Prevention Project Photograph)
December 2002
g-o ~ )t--V
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Baumanometer@ Safety Devices
Figure 7 The bedside mercury
sphygmomanometer has been replaced
with an aneroid unit. (Pollution
Prevention Project Photograph)
By far the most commonly used sphygmomanometer found in hospitals is the Baum
brand wall-mounted sphygmomanometer. Manufactured in New York since 1916,
the Baum sphygmomanometer was a technological breakthrough at that time. Since
then, it has undergone many modifications and improvements and is considered by
some a standard for blood pressure measurement.
Indeed, a testament to the quality of this instrument is the fact that many in use are
up to 30 years old. However, this is also one of the problems with the
"Baumanometers." The majority of instruments in use in the hospitals visited by
California pollution prevention staff were manufactured before Baum began including
safety features that greatly diminish the chance of a mercury spill.
Baumanometers are found in many uncharacteristic places. In fact, many patient
areas that have been turned into offices may still be found with the Baumanometers
mounted on the walls next to desks. Additionally, alternative types of
sphygmomanometers may be found, but the Baumanometers are not removed from
the walls. These wall-mounted sphygmomanometers are seen in many emergency
rooms, treatment rooms, and doctors' offices.
The safety issues with these older model sphygmomanometers include two items
that are inexpensive and easy to fix. One is replacement of the glass mercury tube
with a mylar-coated tube. The other is the insertion of a small "L" shaped metal
"lever lock" that prevents accidental release of the mercury from the tube. Both are
included on new Baumanometers.
Older models of the Baum sphygmomanometers used a clear glass tube. Although
it is somewhat recessed in the instrument's face, it has always been a potential
source of a spill if the tube were broken. Now, hospital personnel can replace the
State of California
Department of Health Services
10
December 2002
g I 1 ' 2--~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
glass tube with one coated with mylar. If the tube breaks, the mylar coating will
prevent shattering and maintain the integrity of the tube. The mylar sheath ends
close to the tube's top end, and a fingernail can detect the change in the tube's outer
diameter. This check can be used to see if existing tubes are mylar coated. The
mylar coated tubes can be purchased from Baum and replacement is not difficult.
They are available for all models of Baum brand sphygmomanometers.
The second safety device is provided free of charge from Baum. On the wall
mounted Baumanometer, the mercury-containing tube is held in place by a lever on
top of the device. The lever is only supposed to be moved when the
sphygmomanometer is removed from the wall and lying on its right side. If this lever
is inadvertently flipped back while the instrument is upright on the wall, the tube is
released and the mercury spills out of the bottom of the tube.
The "L" shaped lever lock is a simple strip of angled metal that is easily slipped
behind the lever to immobilize it. The lock can be removed with no problem using a
screwdriver, but spills are prevented because patients cannot remove the lever lock
without some effort. The lock eliminates the potential to idly flip the lever, which
bored and/or curious patients may do. Vigorous cleaning of the sphygmomanometer
can also allow inadvertent flipping of the lever.
Figure 8 Unless recycled, the
90 sphygmomanometers, along
with thermometers and bougies
(not pictured), would have to be
managed as hazardous waste at
great expense. There are
programs to exchange both
bougies and sphygmomanometers.
(Pollution Prevention Project
Photograph)
Another benefit of inserting these lever locks is that one person in the facility can
make a detailed accounting of where and how many Baumanometers are in the
hospital, and can make a quick visual maintenance check as well.
State of California
Department of Health Services
11
December 2002
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Sphygmomanometer Service Kit
One significant source of mercury that must not be overlooked when conducting a
mercury audit of a hospital is contained in the sphygmomanometer service kit.
Typically, along with spare parts and fittings, such a repair kit will come with one or
more one-pound bottles of triple-distilled mercury. If the service kit has been used,
there may well be another bottle of waste mercury. The service kit may be all that
remains at a facility that has changed out all its mercury sphygmomanometers.
Extra bottles of mercury have also been discovered separate from the kit. One
pound of mercury is about 33 milliliters, or about the volume of a nasal or ophthalmic
solution bottle. The engineering department of a large hospital could easily overlook
such a small container.
State of California
Department of Health Services
12
Figure 9 This style
sphygmomanometer service kit is
provided for the Baum
sphygmomanometer. The mercury
from this kit may be consolidated
with that from other sources to be
recycled. Sphygmomanometer
exchange programs may agree to
accept this source of mercury.
(Pollution Prevention Project
Photograph)
Figure 10 The bottle of "new" mercury
(left) weighs 500 grams (454 grams is a
pound). The waste mercury (right) was
estimated at 0.3 pound. (Pollution
Prevention Project Photograph)
December 2002
'33 ~ J2--~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Esophageal Dilators (Bougies) and Feeding Tubes
Esophageal dilators, feeding tubes, and other devices may use mercury as a weight.
Non-mercury replacements are available for all the mercury-containing devices that
have historically been used in hospital endoscopy departments. The most common
of these is the esophageal dilator or bougie. This device is a long, flexible tube
containing mercury. It is passed down the patient's esophagus and used to dilate
this structure if there are constrictions from various disease processes. Patients
may return periodically to the hospital for this procedure if they have a chronic
problem. A mercury-free alternative is available, containing tungsten gel for weight
instead of the mercury. Additionally, the outside surface is silicone,
which is non-slip when dry, and slippery when wet, making handling easier. The
mercury-containing bougies are made of rubber.
Figure 11 A complete set of
tungsten gel-weighted bougies, stored
in the leather zippered case that
formerly held the mercury ones.
(Pollution Prevention Project
Photograph)
The silicone tungsten gel bougies are green, easily differentiating them from the
orange rubber mercury bougies. At least one company has a trade-in policy that
gives a ten percent rebate toward purchase of a new mercury-free bougie and also
includes free recycling of the old one.
Gastro/Esophageal Tubes Containing Mercury
Miller Abbott tubes are passed down a patient's esophagus, through the stomach,
and into the small intestine to help unblock intestinal obstructions. Historically, these
tubes had a balloon containing mercury to guide the tube into place through gravity.
The mercury balloon can be replaced with a water-filled balloon, or a different
procedure used. Most practitioners have stopped using the Miller Abbott tubes in
favor of a combination of drugs and surgery for obstructions.
The f3lakemorfnube(Sengslakei1=BlaRemofEffObeltshownbelow) is a-device used
to stop the bleeding of esophageal varices (dilated veins in the esophagus). The
tube consists of two balloons; one inflated in the stomach to hold the device in place,
the other inflated inside the esophagus to compress the bleeding vessels. The
State of California
Department of Health Services
December 2002
13
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Blakemore tube is an absolute necessity in the emergency room. Older Blakemore
devices have a mercury-weighted tube allowing them to be placed in a similar
fashion as the Miller Abbot tube. A solid rubber weight replaces the mercury in the
mercury-free device.
Figure 12 A Blakemore tube has three
connections. One inflates the bulb. one inflates the
tube. and one is for gastric lavage and administering
fluids. (Pollution Prevention Project Photograph)
Figure 13 This mercury
barometer, used to standardize
blood gas measurements. can
be replaced with an aneroid
device. (Pollution Prevention
Project Photograph)
Barometers in Respiratory Therapy
In several hospitals visited, the respiratory therapy department had
one of the largest repositories of mercury in the hospital. Hospitals
have historically used mercury barometers to calibrate blood gas
analyzers. One popular brand of barometer in use holds 14 ounces of
elemental mercury. The manufacturer does not sell any safety
devices for this barometer.
Some hospitals have replaced barometers with aneroid units, or simply call their
local airport periodically for a barometric pressure reading.
Thermometers
A possible source of mercury thermometers in the household can be newborn
nurseries. Most hospitals give the new mother a kit with commonly needed baby
items upon discharge after delivery. Previously, these kits would typically include a
new rTl~rC:;LJry tbermQrDeteLThis practice is nQ longeras common,. and hospitals
should provide non-mercury substitutes. A potential method to "get the word out"
about mercury is through childbirth classes. Many hospitals require classes on
childbirth and newborn care prior to delivery. Educators can be encouraged to teach
expectant mothers about alternatives to mercury thermometer use in the home.
State of California
Department of Health Services
14
December 2002
26 O;j )22,-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Mercury thermometers may also be found in refrigerators used throughout the
hospital. Hospital refrigerators must have thermometers, but mercury
Figure 14 Every hospital refrigerator
must have a thermometer. This mercury
thermometer could easily be replaced with an
alcohol/spirit thermometer. (Pollution
Prevention Project Photograph)
Figure 15 On the bottom shelf
of this refrigerator are (left) a
mercury minimum/maximum
thermometer, and (center) a non-
mercury recording thermometer.
Upper shelf, at 1 o'clock, a home
refrigerator alcohol/spirit
thermometer. At 11o'clock, a "lab
quality" mercury one. Mercury
thermometers should be replaced
with non-mercury thermometers and
the number of thermometers in use
could be reduced. (Pollution
Prevention Project Photograph)
thermometers may easily be replaced with alcohol/spirit thermometers. When
conducting the mercury audit an explanation about the P-2 Project and the need to
find all mercury-containing devices such as thermometers helped to encourage
laboratory staff to find all mercury thermometers within their labs.
State of California
Department of Health Services
15
December 2002
21a 112-~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Intraocular Pressure Devices
Prior to ophthalmic surgery, pressure within the eyeball can be reduced to simplify
surgery. Mercury-filled devices, such as the "Wee Bag O'Mercury," have been used
for this procedure. The egg-shaped device contains approximately 600 grams of
elemental mercury. When placed on the eye for 30-45 minutes prior to surgery, the
weight of the mercury on the eyeball keeps fluid from accumulating at the normal
rate, softening the eyeball.
Newer micro-surgical procedures have relegated this device to forgotten drawers in
most facilities because pressure reduction is not always necessary. The stored
pressure reducer may create a waste problem because it may be easily discarded
inappropriately due to its small and inconspicuous size. Staff from the P-2 Project
found a Wee Bag O'Mercury that had not been in use for 14 years stored in the back
of a drawer in one hospital. Effort must be exerted to search for these unused items
and to properly dispose of them while the hospital is actively involved in its mercury
elimination project. No manufacturer could be found that is still making mercury
pressure reducers and no recycling programs are in place for them. It is the
responsibility of the facility to find, recycle, and replace these devices.
Figure 16 Wee Bag O'Mercury ocular pressure
reducing device contains over 600 grams of mercury.
(Pollution Prevention Project Photograph)
A similar device consists of a hard, formed plastic egg with one convex side that
snapped to a headband. Many staff consider the device inferior to the Wee Bag
O'Mercury, raising concerns that staff may revert to using mercury-filled devices.
Without a replacement available, physicians may request repair of one of the old-
style mercury pressure reducers, unnecessarily exposing staff and patients to
possible elemental mercury.
If a replacement is desired, the Lebanon Corporation offers the Honan Intraocular
Pressure Reducer or Eye Softener.llis.a pneumatic devicewith a pressure gauge
to maintain even pressure on the eyeball.
State of California
Department of Health Services
December 2002
16
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
B-5 Fixative
Laboratories widely use a compound called 8-5 fixative. This mercury-containing
fixative has been used in histology to aid in identification of certain cell types. The
tissue is placed in a container with the 8-5 fixative and left until the solution has
penetrated the tissue. Then the tissue is stained and placed onto a slide for
microscopic examination. During the rinse process some mercury is discharged into
the facility sewer system.
Several brands of 8-5 fixative use zinc chloride instead of mercury. Laboratory
suppliers should be able to provide a listing of possible substitute brands.
.^'MDU{~!N iM~~riI'r.<<"j
Sdm~~:;!:1,r!~c.. .1fNc..
i~....}..,J.;.''''' ~~. l:a<h;~.t.,~.w
~ai~imjif;J;;i;;;~ii
jii!;'J1JiN':~;:;lr(j],urI1N
B*5Fixntlve
, . WITH ZING CHL(lHlD~;
4 NON.U'\ZAHf){){Js AJin;flN.~l'l~.
Mercury-Free Cleaning Products
Figure 17 "8-5" Fixative previously
containing mercuric chloride has been
replaced with zinc chloride as noted on
the label. (Pollution Prevention Project
Photograph) .
Small, and potentially overlooked, sources of mercury in the hospital are cleaning
products. The electrolytic process of chloralkali production (manufacture of chlorine
products and sodium hydroxide products) often relies on mercury electrodes,
resulting in mercury contamination of the products. Many cleaning products
consequently contain low levels of mercury. Although these products contain
mercury in quantities that are in parts per million or billion, the amount of cleansers
used in hospitals can result in a contribution to mercury in wastewater through
normal use. Hospital purchasing departments should be aware of this situation and
request mercury-free product verification from their suppliers.
MERCURY CONCERNS IN HOSPITAL OPERATIONS
To ensure safety and contamination control, activities that remove mercury from the
facility must be consistent and predetermined. This may involve establishing a
facility-wide, dedicated mercury management program. The suggested elements of
State of Califomia
Department of Health Services
17
December 2002
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
such a program, which would also include spill reaction and mercury exclusion
policies, are set forth below.
Mercury-Containing Devices In Medical Waste or Sharps Containers
Staff must clearly understand that any broken mercury-containing device must be
managed as hazardous waste even if contaminated by medical waste. Whether
broken or intact, mercury devices must never be placed in red bag medical waste
containers or sharps containers, but rather collected for recycling or hazardous
waste disposal. Even though the increased use of digital and other non-mercury
substitutes has drastically reduced the incidence of broken fever thermometers, this
principle applies to clinical, laboratory, and all other sources within the healthcare
facility.
Mercury Collection Areas
Mercury-containing material will ultimately either be recycled or disposed as
hazardous waste. To assure all devices earmarked for removal actually leave the
hospital, a single, dedicated, secure pre-collection location for consolidation of
mercury, mercury-contaminated waste from spills, and mercury-containing devices is
a necessity. Procedures for removal of mercury-containing material to consolidation
locations must also be established.
Some practitioners may be reluctant to switch from familiar and trusted mercury-
containing devices to mercury-free models. To prevent these practitioners from
retaining mercury-containing devices when the hospital is trying to replace them,
change-out procedures must dovetail with the transport system.
Transporting Mercury Devices
Change-out activities, whether for bedside sphygmomanometers, mercury
thermostats, or mercury devices in the boiler room, should also be coordinated with
planned secondary containment and transportation to a prescribed storage location
arranged in advance. Ad hoc improvements or changes are to be discouraged.
Ultimately, mercury-containing items will be consolidated at the facility's hazardous
waste storage area for recycling. Procedures should clearly state proper storage
methods at each storage area and scheduled transportation to the consolidation
area.
State of California
Department of Health Services
December 2002
18
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Spill Clean Up
It is important to have individuals available at all times who are trained and familiar
with management of mercury spills and the use of a spill kit. Notices should be
adequately posted throughout the facility listing these individuals and how they may
be contacted. A mercury spill must be treated as a hazardous waste spill. Staff
throughout the hospital must be informed of procedures for notifying of the trained
personnel for mercury clean up. Training and clear communication on the
importance of proper procedures in mercury clean up are imperative.
Spill Clean Up Kit
Spill clean up kits should be easily accessible to staff on call for mercury clean up.
Any laboratory or safety supplier will have choices of spill clean up kits available.
Some of the components the kits should contain are:
. Mercury Suppressant - a solution that will prevent vaporization of elemental
mercury.
. Mercury Indicator - a powder that changes color to indicate the presence of
mercury .
. Mercury Absorbent - a powder that amalgamates with mercury to facilitate
clean up.
. Mercury Aspirator or Vacuum - a syringe to a dedicated vacuum for mercury
and used to suction mercury from surfaces. It is very important that regular
vacuum cleaners are not used on spilled mercury, as they spread the
contamination through aerosolization of the mercury particles.
. Clean up materials - gloves, safety glasses, screw cap containers, plastic
bags, paper towels, and similar clean up aids.
Mercury spill clean up kits can be made in-house or purchased from a safety
equipment supplier.
The cost of a vacuum specifically for mercury may be prohibitive for small facilities.
Hospital groups may purchase one to share between facilities. Hospitals in a city or
region could also cooperatively purchase one mercury vacuum to share. Some
governmental agencies and university hazardous materials emergency response
departments or companies have mercury vacuums available. Be prepared and know
whom to contact beforetb~_~i11 ~ccurs.
State of California
.Department of Health Services
December 2002
19
901122--
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Keeping Mercury Out of the Hospital
After removal of mercury sources from the hospital it is important to keep new
sources from entering the hospital. To help keep mercury from entering the hospital,
purchasing personnel need to become knowledgeable and committed to buying
mercury-free items when available. Facilities should require their departments to
inform the purchasing department when items requested. contain mercury and why
available alternatives are not appropriate. Conversely, personnel involved in
purchasing must continually update their familiarity with the availability and
applicability of new mercury-free alternatives.
Mercury Assessment
The mercury assessments conducted as part of the P-2 Project were much more
thorough and effective when a limited number of people conducted the assessment.
A three-person team is ideal for conducting the assessments, as that number does
not crowd the area being surveyed or, more importantly, stifle staff interaction.
Incidental comments from staff working in the area being surveyed often led to the
discovery of mercury-containing devices that may have been overlooked without
their input. Where larger assessment teams were used, comments from staff and
supervisory personnel were reduced. The smaller team also was able to cover more
areas of the facility in a rapid fashion. When smaller teams were used, they
surveyed areas not previously targeted, in addition to the areas staff had planned to
visit. These more comprehensive surveys often resulted in fewer follow-up activities
needed by the hospital staff.
Plumbing Traps
Residual mercury from past disposal practices in hospitals has been known to
collect in plumbing traps. Lack of awareness of this hidden mercury may result in
spills during plumbing or demolition activities if the appropriate staff does not provide
secondary containment when disassembling a trap. This can easily be
accomplished by placing a shallow bucket or other similar container below the
plumbing traps prior to disassembling the trap. Staff training greatly lessens the risk
of uncontained contamination.
Fluorescent Lighting
Measuring mercury contributed by fluorescent lighting is a formidable task. The
engineering department from one of the hospitals participating in the P-2 Project
provided a complete inventory of all fluorescent fixtures, from which project staff
could calculate a conversion factor of 0.57 milligrams per square foot (mg/ft2) for use
throughoutallthe hospitals. This was based on the . premise Ihat,diJelOmutl.lal
compliance with a wide variety of regulations, lighting in each of the participating
hospitals could justifiably be approximated to be the same level as found at the
hospital that undertook the inventory of fluorescent fixtures.
State of California
Department of Health Services
December 2002
20
0/ ~ }?'),
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Effective March 7, 2000, the California Department of Toxic Substances Control
adopted emergency regulations (the universal waste rule) that require all fluorescent
tubes be either recycled or disposed of as hazardous waste.
Electrical Supplies
The electrical supply for a large hospital may employ certain mercury-containing
devices such as high-current service cutoff switches, relays, and mercury vapor
circuit breakers. These devices are not hospital specific, and there are no
substitutes available. These devices, common to many large commercial and
industrial facilities, are self-contained and physically isolated, minimizing risk of
mercury escape. They are also very long-lived, so their replacement, and the
resultant generation of waste mercury, typically occurs coincidentally with other
major electrical changes. The facility plan should reference any such devices in use
in the facility, and prescribe procedures for recycling or disposal at time of
replacement.
Calculations and Quantification
The P-2 Project relied on several sources for quantifying mercury contained in a
particular device. The capacities of the two kinds of barometers found were also
estimated volumetrically, by calculation from the measured heights and internal
diameters of the cisterns and columns. Although no mercury was actually found,
measurement of bulk mercury from plumbing traps was to be done volumetrically.
The following procedure should be followed if mercury is found. Decant the majority
of the trap aqueous liquid, pour the mercury and any remaining water into a
graduated cylinder and note the volume of the denser mercury.
The weight of mercury for light fixtures was based on an actual fixture inventory
performed by one participant facility. Published information from a manufacturer of
low-mercury f1uorescents states that conventional fluorescent tube production
technology could achieve no less than 22 milligrams of mercury per four-foot tube.
Since an underestimate would be counter to the best interests of their advertising,
the P-2 Project accepted that number as a conservative minimum. The facility
inventory yielded a multiplier of 24,156 linear feet of tube. The facility calculated its
mercury total from fluorescent lights to be 133 grams. With 233,900 square feet of
floor area in the facility, the mercury in fluorescent lights was 0.57 mg/ft2. The P-2
Project staff assumed that all hospitals would be required to meet the same lighting
standards and therefore used the 0.57 mg/ft2 factor in calculating fluorescent tube
mercury for all other facilities based upon their square footage.
FactQry~p~GifiQC:1!iQI1?,^,~r~j)articularly difficult to acquire. Contrary to the project
goal of eliminating mercury-containing devlcesfOffaciIities, the device
manufacturers continue to sell mercury-containing products.
State of California
Department of Health Services
December 2002
21
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Business Plan
The 1999 Memorandum of Understanding between the U.S. EPA and the American
Hospital Association targeted 2005 for the virtual elimination of mercury in waste
streams from hospitals. All hospitals should ascribe to that goal. Following a
mercury audit, hospitals should develop a business plan for replacing mercury-
containing devices with mercury-free devices. The business plan should be based
on the findings and utilize the data generated from the audit. The business plan
should consider three matters of fact that may impact on the processes that they
choose in eliminating mercury from their hospital.
. The practical feasibility, based on use, change-out and disposal costs and the
ability to overcome resistance to new devices may drive the rate at which
change can occur.
. Certain devices or products, particularly diagnostic lab packs and multi-dose
vaccines (preserved with thimerosal) are often not available without mercury.
Mercury reduction can proceed only at a pace determined by the emergence
of suitable substitutes in the marketplace.
. New earthquake standards developed by the Office of Statewide Health
Planning and Development may require structural changes that include
demolition or remodeling of the facility. If demolition or remodeling of the
facility is undertaken, caution must be exercised for the removal of mercury-
containing fixtures. Many of these mercury-containing fixtures may be
presently unknown, such as mercury in plumbing traps and silent mercury
light switches that are virtually indistinguishable from their non-mercury
counterparts. Discovery and change-out of such fixtures where appropriate is
advised, so that they are not present when demolition or reconstruction
commences.
FOLLOW UP
Along with reduced use of mercury-containing items, and their removal from the
hospital, comes another responsibility-keeping out new mercury sources. Educate
the purchasing department in each facility to be alert for the possibility of
reintroduction of mercury and to scrutinize vendor agreements. In addition, other
departments must be alert that devices that have been removed are not replaced
with other mercury-containing devices. The laboratory must continue to use zinc-
based fixatives, and to be alert for thimerosal preservatives in commercially
prepared stains. Wherever possible the pharmacy should encourage the use of
tl"limeresaf-free vaccines; Rarely ,resistanceto these changesftbh1professional
staff has been observed. Administration staff at each hospital must be ready to step
in if mercury-containing devices reappear following removal.
State of California
Department of Health Services
December 2002
22
13 aj 12-).,
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
HAZARDOUS MATERIALS MINIMIZATION
Wherever possible hospitals should reduce the use of hazardous materials in an
effort to curtail the generation of hazardous waste. Hospitals will continue to need
devices containing hazardous materials, but in an increasing number of cases
recycling is being required after use. New universal waste regulations require
fluorescent lights and cathode ray tubes to be sent for recycling instead of to the
landfill. Additionally, several easy to implement practical steps can be initiated within
the hospital to help achieve a reduction in the hazardous waste stream.
The first step is to develop a formal mission statement outlining the hospital's
commitment to source reduction. It is important to encourage employees to
participate in hazardous materials source reduction as a way to reduce or eliminate
hazardous waste generation. Hospitals should consider an incentive program to
encourage employees to follow good housekeeping practices that reduce hazardous
materials use. An incentive program can easily be instituted through an employee or
team recognition or awards program.
A second step involves training employees on source
reduction techniques and encouraging them to
develop innovative ideas to reduce hazardous
materials use within the hospital. Training should
include proper handling and storage of hazardous
materials so that spills can be prevented or
immediately responded to so as to minimize their
impact. Trade associations, equipment vendors, and
local environmental health programs often sponsor
employee training on this subject as part of the
services they provide to hospitals. An on-going
commitment to employee training in hazardous
materials source reduction must be made and include
periodic training sessions held to keep employees
current so that they can perform their duties more
efficiently.
A third step to reduce the hazardous waste stream is
to implement a program of inventory controls for
hazardous materials. A computerized inventory
enables policies that facilitate sharing of materials
among departments and prevent duplicate purchases.
Such policies save money and reduce the amounts of hazardous waste generated
from leftover materials.
Figure 18 Environmental Services
staff using the MicroScrub mop system.
(Pollution Prevention Project
Photograph)
A fourth step involves using improved technologies that reduce hazardous wastes.
The MicroScrub mop system is replacing the traditional wringer mop that was
patented in 1893 and has been in use since then. The wringer mop system uses
State of California
Department of Health Services
December 2002
23
Cfl.! ~ 12~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
disinfectants in a bucket containing two to three gallons of water, mopping three to
four rooms before emptying the bucket in a janitor's sink and refilling for use in
another three to four rooms. The MicroScrub system uses a single flat cloth mop
per room, with the cloths stored until use in a gallon bucket with a third of a gallon of
water covering the cloths. When a cloth is needed it is pulled from the bucket and
used in a single room. When the floor of the room is finished being mopped, the
mop cloth is removed
Figure 19 Chemical dispensing unit
mounted in a janitorial closet ensures precise
arnount of chernical is used. (Pollution
Prevention Project Photograph)
and placed in a bag and a new one used for the next room. At the end of the day all
the dirty cloths are laundered and dried for use the next day. String mops last
approximately a month before needing to be replaced. MicroScrub mop cloths have
been in use at Sacramento's Mercy General Hospital for over three years with no
signs of wear. Additionally the MicroScrub system is lighter and easier to use, thus
reducing repetitive motion injuries. Some hospitals have paid for implementing the
system through risk management funds from anticipated ergonomic injury reduction
savings.
The use of chemical dispensing units within hospitals can reduce the amount of
chemicals used by removing the "human factor" in "eye-balling" the quantity of
chemicals to be used. Suppliers install chemical dispensing units within janitor's
closets where chemical-using equipment is filled. Different sized dispensing heads
meter out a measured amount of chemicals as required for the cleaning procedure
being performed. Facilities realize cost savings by reducing the amounts of
chemicals used.
SubstituUng.. non-t'lazardous or less-hazardous materials for hazardous materials can
reduce or eliminate the hazardous waste stream. Some hospitals have routinely
used hepatitis B quaternary disinfectants daily on floors. Infection control specialists
have recently directed that this process should only be used for cleaning and
disinfecting blood spills, and that daily floor cleaning can be accomplished using a
State of California
Department of Health Services
December 2002
24
150;} 12-1-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
floor soap or clear water. This process will assist infection control within the hospital
by reducing the possibility of developing resistant strains of pathogens from the
continued use of hepatitis B quaternary disinfectant cleaners. Additionally, this
reduces the amounts of chemicals used within the facility and the cost associated
with their use.
Hospitals can substitute gelled electrolyte lead-acid batteries (commonly called "gel
cells") for traditional wet cell lead-acid batteries in several sizes of floor scrubbing
and polishing machines. The gel cell is a "recombinant" battery. The oxygen that is
normally produced on the positive plate in all lead-acid batteries recombines with the
hydrogen given off the negative plate. The recombination of hydrogen and oxygen
produces water that replaces the moisture in the battery. This makes the gel cell
battery maintenance-free because it need not be topped off with water like wet cell
batteries. A gel cell battery is pressurized and sealed using special valves. This
self-contained feature prevents battery acid spills and the need for special cleanup
kits. Recharging does not produce fumes, which is very beneficial in hospitals.
Figure 20 Gel cell batteries installed on a floor
scrubbing machine. (Pollution Prevention Project
Photograph)
A fifth step to reduce hazardous wastes is to prepare and implement a hazardous
materials spill response plan. An immediate response to hazardous materials spills
or improper storage of hazardous wastes can minimize employee or patient
exposure, damage to the hospital facility and surrounding environment, liability, and
disposal costs. Routine inspections of hazardous materials containers and
hazardous waste storage drums can identify potential problems such as leaks and
improper storage practices that could result in costly remediation if action is not
taken to remedy the situation. Periodic drills to respond to hazardous materials
spills can improve the readiness of hospital response staff to take appropriate action
during an emergency. .A quick and appropriate response will reduce the amount of
hazardous wastes generated during a spill and reduce the cost of the cleanup.
Hazardous-materials shouTdbest6red' separately from non-hazardous materialsto
prevent the creation of larger amounts of hazardous waste if a spill takes place in
the storage area. Hazardous materials are best protected in a covered area where
they are not exposed to the elements. Sunlight has the potential to degrade some
State of California
Department of Health Services
December 2002
25
q& '1 ! 2-t-
Departrnent of Health Services Hospital Pollution Prevention (P-2) Strategies
hazardous materials and absorbed heat can raise the pressure inside containers,
creating potentially dangerous conditions.
State of California
Department of Health Services
December 2002
26
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Department of Health Services Hospital Pollution Prevention (P-2) Strategies
CHAPTER IV
SOLID WASTE MINIMIZATION
Health care facilities generate approximately two million tons of solid wastes per
year. This represents one percent of the Nation's solid waste stream. Table 1
represents a breakdown of the typical hospital solid waste stream.
Table 1.
Composition of a typical hospital solid waste stream
54%
19%
15 %
3%
2%
7%
100.0 %
Paper represents the largest portion of the hospital solid waste stream and is
composed of cardboard, kraft, high-grade paper, newspaper, ma~zines, phone
books, directories, and other mixed paper. Many hospitals have instituted programs
to bale and recycle cardboard.
Figure 21 Many hospitals
recycle cardboard. (Pollution
Prevention Project Photograph)
The second highest percentage of the hospital solid waste stream is organic wastes
including yard wastes. The largest component of the organic waste stream from
hospitals is food wastes.
Plastics; at 14.6 percerit,-represent the third highest percentage of the hospital solId
waste stream. If significant reductions in the solid waste stream are to be achieved,
these portions of the waste stream are the leading candidates for intervention
strategies.
State of California
Department of Health Services
December 2002
27
121'zv
Departrnent of Health Services Hospital Pollution Prevention (P-2) Strategies
PERFORMING THE SOLID WASTE AUDIT
Hospitals should select the solid waste audit team from staff knowledgeable with the
layout and waste operations of the facility. Candidates for the team are managers,
supervisors or others from housekeeping, environmental management, and health
and safety, as well as infection control. The team should be small enough so as not
to disrupt the operations of the areas being reviewed. The major difference between
the mercury assessment discussed in the preceding chapter and the solid waste
audit is that the mercury assessment looks for fixed or transient locations of
mercury-containing devices, equipment or materials, whereas the solid waste audit
reviews the solid waste stream that is being generated and moving through the
facility. A team of three to four individuals works best in conducting the solid waste
audit. The team walks through the facility and notes solid waste handling practices
and observes what wastes are being disposed of in the waste receptacles. The
team needs also to gather pertinent data as to the amount of solid wastes being
generated and the solid waste company handling the waste stream. Note must be
made of the amount of material being diverted from disposal through reduction,
reuse, and recycling activities as the total amount of waste generated equals the
amount disposed plus the amount diverted.
The audit should note how wastes are handled and stored. The team should
document the location of recycling containers and other devices, such as cardboard
balers. If possible, the cost of the recycling activities should be obtained. This
information can be valuable should reduction strategies eliminate the need for
recycling of specific products. Documenting the success of solid waste minimization
efforts requires knowledge of the costs before the minimization interventions.
SUCCESSFUL SOLID WASTE REDUCTION STRATEGIES
Most of the hospitals that participate in the P-2 Project had already instituted
cardboard recycling prior to joining the program. However, there is a cost to
recycling the cardboard. Staff must breakdown the cardboard containers, haul them
to a baler, and bale them. The Northern California Kaiser Hospitals use plastic totes
to send materials from their central supply warehouse to the participating hospitals.
The totes replace the cardboard containers and greatly reduce the amount of
cardboard needing to be baled for recycling. When empty, the plastic totes stack
within each other and are easily stored while awaiting pickup and return to the
warehouse for reuse. Color-coding the plastic totes assists the receiving facilities in
knowing where to send the supplies (such as medicines in yellow totes to the
pharmacy). Gray totes are packaged for specific floors designated on a three-by-
five card placed in an address area on the tote. This expedites supply delivery and
reduces the cost-of processing thematertal thrbugh cehtral. supplY.
State of California
Department of Health Services
December 2002
28
qq ~ (2-V
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Figure 22 Empty plastic totes nested and
ready for return to warehouse for reuse. (Pollution
Prevention Project Photograph)
Most communities within California have instituted recycling programs for
households, and employees often have commented that when they come to work at
the hospital they are surprised to find that little recycling is being done. Hospitals in
many California localities can work with their waste authorities and refuse
companies to implement recycling programs for aluminum cans, paper, and glass.
The waste authorities often have lists of recyclers for various types of materials and
can even be a source of small grants to assist the hospital in getting their recycling
program underway.
California hospitals have recently been presented with an opportunity to recycle blue
wrap and other plastic films such as shrink-wrap, stretch wrap, bubble wrap/blister
pack, and plastic bags. Marthon Recovery is a raw material recovery program
initiated by Boise Cascade Corporation to procure polyethylene and polypropylene
plastic films waste. They have established a receiving center in Oakland, California,
and are building a plant in the State of Washington where the recovered plastic film
waste will be used to produce a wood/plastic composite building material that will be
in the marketplace in the near future. Through this process, hospitals avoid the cost
of solid waste disposal for their plastic wrap waste and it in turn is converted into a
new building material. Clean Source, a hospital supply company, is assisting this
process by backhauling blue wrap and plastic films from the hospitals they service
so that waste stream can be easily taken to Marathon's Oakland receiving center.
Blue wrap, which is ubiquitous in hospitals, and other plastic film products are being
converted from a waste stream component into a valuable recycled product.
State of California
Department of Health Services
December 2002
29
} trO 1 )~.v
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
Figure 23 Blue wrap used to wrap surgery equipment
for sterilization is being recycled and used with wood chips to
make wood siding. (Pollution Prevention Project Photograph)
Many communities in California have instituted yard waste composting to remove
this component of the solid waste stream. Hospitals should check with their waste
authority to obtain information about possibilities within their locality for diverting yard
wastes from the solid waste stream.
Norcal Waste Systems, Incorporated, has instituted a program for composting yard
wastes, pallets, and food scrap wastes from San Francisco restaurants at one of
their landfill sites in Northern California. Norcal runs the wastes from these three
waste streams through a chipper and then places it in plastic silage bags (capable of
holding 200 tons of material) for eight weeks of composting, with controlled
temperatures aiding the process. The compost that results from this process has
been used as a soil amendment in agricultural and horticultural operations. Norcal
sends the used plastic silage bags to Marathon for use in their plastic film recovery
program. Norcal is exploring the feasibility of using this process for handling the
food waste from hospitals. By composting the yard and food wastes, which
compose the second largest category of solid wastes from hospitals, this process
could reduce the hospital's solid waste stream by approximately 19.1 percent.
Figure 24 Food waste composting is
chipped and rnixed with yard wastes and pallets in
silage bags to create a soil amendrnent. (Pollution
Prevention Project Photograph)
All activities to reduce the solid waste stream in hospitals must be closely tracked so
that progress can be measured. The reduction of the solid waste stream should be
State of California
Department of Health Services
30
December 2002
/0/ <r;f /2,,?/
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
prominently displayed in graphic form in the hospital so that staff and the public can
see the achievements.
State of California
Department of Health Services
Decernber 2002
31
102- ~ J 2-,~
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
CHAPTER V
MEDICAL WASTE MINIMIZATION
Although medical waste management practices will vary from one hospital to
another, a common ingredient in all effectively managed medical waste systems is
leadership. Effective management of medical waste requires the hospital to meet all
legal obligations, achieve public and environmental protection, and accomplish this
in a cost-efficient manner. Overlaying the proper management of medical waste is
the increasing attention on reducing the medical waste stream through pollution
prevention activities. Balancing these issues is a challenge that requires a
commitment from the highest levels of management and from staff entrusted to carry
out the medical waste handling activities throughout the hospital.
MEDICAL WASTE MANAGEMENT LEADERSHIP
Many people think that the terms leadership and management are interchangeable.
University of Southern California professor, Warren Bennis, provides the distinction
between leaders and managers as follows: "Leaders are people who do the right
things; managers are the people who do things right." He acknowledges that both
play critical roles within the organization; but they differ profoundly. People in top
positions are often found doing the wrong things well. 4
Knowing what is right for the hospital is at the heart of the leader's responsibilities.
Burt Nanus in his book, Visionary Leadership, emphasizes that twenty-first-century
organizations demand visionary leadership. He indicates that most organizations
are faced with accelerating technological changes, a diverse staff of intelligent
workers, and a variety of customer and constituency needs that would cause most
organizations to self-destruct if not for a sense of direction provided through
management's vision of the future. Visionary leadership is vital to align the
thousands of disparate tasks and tap the energies of the workers within the
organization.s This is especially true in attempting to reduce medical waste while
ensuring its proper handling in a complex organization such as the hospital setting.
Proper management of medical waste is just one of many systems driving the
hospital towards fulfilling its overall vision of providing excellent health care to its
clients and the greater community at large. The vision helps to frame the "right
things" upon which the hospital should be focused. Absent a picture of a future state
to strive towards, we are condemned to the paradigm of: "This is how we have
always done it around here." Visionary leadership also supports the concept of
continuous improvement in the ways systems are operated. The P-2 Project always
requires the approval of the top management of the hospital before activities are
initiated SQ that tb~irQLJy-in isassLJJed.
4 Bennis, Warren, Why Leaders Can't Lead - The Unconscious Conspiracy Continues, Jossey-
Bass Publishers, 1991, page 18.
5 Nanus, Burt, Visionary Leadership, Jossey-Bass Publishers, 1992, pages 178-179.
State of California
Department of Health Services
December 2002
32
IDJ 0/ t2-2-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
SUCCESS THROUGH STAFF PROCESS OWNERSHIP
An unnecessary burden is placed upon managers if they shoulder the sole
responsibility for the performance of their programs. A great deal of wasted effort
and inefficiency results when intelligent workers must wait to be commanded or
directed to carry out their work tasks. In their national bestseller book, Flight of the
Buffalo - Soaring To Excel/ence, Learning To Let Employees Lead, James Belasco
and Ralph Stayer indicate, "... that the key to organizational success today is in
getting the people to want to own the responsibility for their own performance.,,6
Effective and successful management of the medical waste system within a hospital
can best be accomplished when everyone involved is allowed to take responsibility
and ownership for the process. .
Representatives from the various groups of staff involved with the medical waste
stream throughout the hospital can participate on teams to establish strategies for
reducing the amounts of medical wastes generated and for handling the remaining
medical waste stream. Such team participation can increase coordination across
the spectrum of professional classifications within the hospital. The team should
consist of those generating the waste, those handling it within a designated area or
floor, those responsible for infection control, those moving it through the facility to
treatment or storage, and those responsible for purchasing or contracting for these
waste services. Representatives from these groups can jointly develop strategies
that are understood by staff in all the various organizational groups within the
hospital who are involved with the medical waste stream. When employees from
these groups own the process, improvements and increased accountability are likely
to follow.
Most of the principles of medical waste minimization can be applied to other systems
within the health care facility, resulting in more cost-efficient operations and an
improved bottom line on the balance sheet. Medical waste minimization centers on
eliminating or reducing the medical waste stream. There are several measures that
can be instituted to achieve medical waste minimization including the following:
.
Waste prevention - eliminating the generation of medical waste
Source reduction - reducing the amounts of medical waste generated
Re-use - finding another use for a component so it does not become part of
the medical waste stream
Recycling - handling or treating the material so it can be used in another
process
.
.
.
DEVELOPING STRATEGIES TO MINIMIZE MEDICAL WASTES
Essential activities in implementing a medicalwaste minimization program are to
recognize the various waste streams, to initiate strategies to ensure that staff is
6 Belasco, James A., and Ralph C. Stayer, Flight of the Buffalo - Soaring To Excellence,
Learning To Let Employees Lead, Warner Books, Inc., 1993, page 249.
State of California
Departrnent of Health Services
December 2002
33
! 0 Ii 1'tll.-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
aggressively trained to minimize the generation of wastes in a higher waste stream,
and to ensure that the wastes do not become unnecessarily combined. These tasks
will require leadership by management in developing policies and training staff. For
example, diapers from a nursery can be handled as solid waste; but when medical
waste hampers are placed in the nursery, staff often utilize them for disposal of the
diapers. This practice will unnecessarily increase the cost for disposing of the
diapers because these items must now be handled as medical waste. Management
can minimize the medical waste stream by implementing a policy directive that baby
diapers are to be disposed as solid waste. This action should be reinforced through
a training program on waste handling and waste stream monitoring.
Management and staff must be committed to medical waste minimization to make it
a successful program within the hospital. Management must communicate the need
for medical waste minimization in a manner that inspires staff to implement positive
actions in this direction. This can be done by publishing a "medical waste
minimization strategy" to guide the waste minimization efforts within the facility. The
strategy should state the goal of the medical waste minimization program and
identify new policies for handling and discarding medical waste and the non-medical
wastes generated in the same setting. Other possible elements of the medical waste
minimization strategy include:
.
Plans for staff training and follow-up monitoring
A monthly tracking mechanism for waste minimization
Recognition or awards for achieving milestones in implementing the strategy
Formation of a team or council to oversee and coordinate the medical waste
minimization strategy
Tangible reports, graphs and feedback to show results
.
.
.
.
The use of bar coding systems can assist in the waste minimization efforts by
measuring and recording the medical wastes being generated in the various units of
the facility on an on-going basis. Storing the assessment data in a computer for
retrospective analysis can be used to show progress as the medical waste
minimization efforts are implemented.
It is important to develop good baseline data of the amounts of waste generated
prior to implementing the waste minimization program. Medical waste generation
data from the various units within the health care facility should be recorded on a
Pareto Chart with the amounts of waste displayed in descending order from the left
side of the chart. Pareto analyses can easily determine the highest medical waste
generating areas in which the minimization strategies should be initiated. Displaying
the medical waste being generated by the various units in the facility can assist in
developing "buy-in" for implementing waste minimization strategies. This information
shou~d be--disI'layed" and communicated throughoutthefacitity.
State of California
Department of Health Services
December 2002
34
I 05 OJ J Z:2..
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
MEDICAL WASTE MINIMIZATION PLANNING
Top management within the health care facility should formally approve the medical
waste minimization strategy and they should assign responsibility for the program.
This responsibility can reside with an individual, a department head, team, or
council. The individual or team responsible for implementing and coordinating the
medical waste minimization program should be empowered by management to work
across organizational boundaries in carrying out the program. Management should
also communicate an expectation of cooperation from every operational unit and
. individual throughout the organization.
MEDICAL WASTE MINIMIZATION ASSESSMENT
Data regarding the current waste streams generated within the health care facility
need to be gathered during the assessment phase of the program. These data
should include the amounts of waste generated for the various waste streams and
the cost of disposal or treatment. For the analysis of the medical waste stream, the
medical waste generated per patient population in the facility or served by the facility
should be completed for future comparisons of the effectiveness of the waste
minimization program.
Assessments should provide useful information to assist in determining where to
initiate the waste minimization program in order to obtain maximum waste reduction
and cost efficiency. Plotting the amounts of wastes generated by the different parts
of the health care system also gives staff from each of these areas knowledge as to
the potential gains that can be recognized for waste minimization in their areas of
the facility. The ability to document success stories at a later date is contingent on
having accurate initial assessment data.
MEDICAL WASTE MINIMIZATION IMPLEMENTATION
Following completion of the medical waste minimization assessment the facility
should be ready to implement the medical waste minimization program. Based on
assessment data, the major medical waste generating areas of the facility should be
targeted. These areas have the potential for the greatest accomplishments. There
may be resistance to the waste minimization program because it is something new.
Busy staff may build barriers to the successful performance of the waste
minimization program because they may perceive it will create more work for them.
To overcome these barriers will require excellent communications about the waste
minimization program to everyone involved. Hospitals that have implemented
aggressive medical waste minimization programs have achieved reductions of 30 to
40 percent in the medical waste stream. This degree of waste reduction results in
sighificanfc6st savings. ._--~--- -. -_..~----
Documenting success requires a tracking program that measures the waste being
generated in the various parts of the facility. As waste minimization strategies are
State of California
Department of Health Services
December 2002
35
t1)C:, 1 /;2-2-
Department of Health Services Hospital Pollution Prevention (P-2) Strategies
initiated, their effectiveness can be measured by the tracking system. Impressive
results may be achieved early in the program as easy-to-implement actions can yield
big reductions. As the medical waste minimization program in the health care facility
progresses, it may become harder to meet percent reduction goals because the
easiest reductions have already been achieved. Reductions achieved over the life of
the program should always be shown in order to give an indication of the overall
accomplishments of the program since its inception.
When a strategy for medical waste minimization is initiated and the results are less
than expected, a thorough analysis should be made of the strategy. Learning from
failures is important so that the same strategy will not be repeated. The ability to
modify the strategy and test it again for effectiveness should be an integral part of
any minimization program. Strategies that work well should likewise be studied for
lessons that can be applied in other areas of the hospital, and shared with other
facilities through technical publications or over the Internet. The workable medical
waste minimization practices should be incorporated into the on-going operations of
the health care facility through policy directives to staff.
The status and results achieved should be communicated to all staff throughout the
hospital and incorporated into new employee orientation. Charts showing
achievements should be prominently displayed to encourage further waste
minimization. Storyboards depicting the actions taken and results achieved within
the various units of the facility should be developed. Success stories should be
communicated to the neighboring community to demonstrate that the hospital is a
good environmental steward.
SUCCESSFUL MEDICAL WASTE REDUCTION STRATEGIES
One of the most important factors in reducing medical waste is "location" of the
medical waste container. Medical waste containers placed next to sinks will
inevitably collect paper towels and other solid waste. Environmental services or
house keeping staff must be properly trained as to placement of the containers in
order to curtail improper disposal of solid waste. Staff that generate medical waste
must also be trained in the need to keep solid waste out of the medical waste
stream. Hospitals can emphasize the importance of segregating these two waste
streams by producing a fact sheet comparing the high cost of disposing of medical
waste versus solid waste.
Figure 25 Medical Waste containers by the sink
will be filled with paper towels instead of medical waste
demonstrating theimportance of theJocation of .
medical waste containers. (Pollution Prevention
Project Photograph)
State of California
Departrnent of Health Services
December 2002
36
J071' r~~
Departrnent of Health Services Hospital Pollution Prevention (P-2) Strategies
Sometimes reductions come from unanticipated areas. The P..2 Project learned of a
bag manufacturer that was interested in designing a new red bag for medical waste
use. The manufacturer set up a meeting with P-2 Project staff to gain insight as to
what they would like to see in a new red bag product. Several requests had been
received by the P-2 staff members from hospitals interested in using red bags with
recycled plastic content. No such bags were available and some manufacturers
claimed they could not make them. The new bag manufacturer indicated that he
thought it would be possible to use up to 20 percent recycled content in production
of his red bags. Additionally, he would use a "star seal" at the bottom of the bag that
strengthened the bag by distributing the weight of its contents against all sides. The
manufacturer was provided with the strength requirements for approval of the bags
that consisted of passing the American National Standards Institute (ANSI) 160
gram dropped dart test. The manufacturer developed a new bag that passed the
ANSI test using a dart weighing 180 grams. The high-density plastic bag and initially
contained 20 percent recycled plastics content. The bag weighed from 6 to 20.48
pounds less per 100 bags than the low-density plastic red bags typically in use and
was approximately 15 percent cheaper. The manufacturer calls this new product the
BioEJite bag. The bag has been well received by the hospitals using them. Through
continuous improvement practices the manufacturer has raised the recycled plastic
content of the BioEJite red bag to 30
percent. The company has also started
manufacturing a BioEJite laundry bag
with greater amounts of recycled plastic
content.
Several hospitals implemented a
reusable sharps container program
initiated by the Integrated Environmental
Systems (IES) medical waste treatment
company. However, this service was
discontinued when the company was
sold. Reusable sharps containers are
approved as a medical device by the
federal Food and Drug Administration
and are thicker than conventional sharps
containers. It is estimated that the
reusable sharps containers can be used
for five or more years before needing to
be taken out of service. At an off-site
medical waste treatment facility the
reusable sharps containers are
mechanically opened and their contents
dumped into an autoclave cart for
processing. The containers are washed,
sanitized and reassembled for return to the hospital for reuse.
Figure 26 BioElite high-density plastic red bag is
made using 30 percent recycled plastic. It weighs less
thanstandarG~low-densit-yred-bags, (Pollution ~-
Prevention Project Photograph)
State of California
Department of Health Services
December 2002
37
) 08 <>})2-2-
Departrnent of Health Services Hospital Pollution Prevention (P-2) Strategies
P-2 Project staff studied a 250-bed hospital that was considering starting the
program and found through purchasing department records that the hospital used
18,000 sharps containers in a year. Calculations based on the size and weight of
the various containers revealed that the hospital could divert 13 tons of plastics from
their medical waste stream by purchasing a reusable sharps container service. This
has been shown to be the most significant methodology for reducing the medical
waste stream.
State of California
Department of Health Services
December 2002
38
J oq " 12-~
EXHIBIT B
Liquefaction Susceptibility
Map
Susceptibility Level
. Very High
. High
Moderate
. Low
Very Low
= Major Roads
Local Roads
EB
Scale: 1 Inch equals 0.33 miles
This rnap is intended for planning use only
and is not intended to be site-specific.
Rather, it depicts the general ~sk within
neighborhoods and the relative risk from
community to cornmunity. Mo~e detailed
maps are needed for site deve:lopment
decisions.
This rnap is available at
http://quake.abag.ca.gov
Source:
This map is based on work by lNilliam
Lettis & Associates, Inc. and USGS.
USGS Open-File Report 00-444, Knudsen
& others, 2000
For more information visit:
http://geopubs.wr.usgs.gov/
open-file/ofO0-4441
Map Prepared by the ABAG Earthquake Program.
April 2004.
ABAG!]
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DRAFT
DRAFT
Zanni
Commission Minutes
CALL TO ORDER/ROLL CALL
A regular meeting of the City of Dublin Planning Commission was held on Tuesday, May 8,
2007, in the Council Chambers located at 100 Civic Plaza. Chair Schaub called the meeting to
order at 7:02 p.m.
Present: Chair Schaub, Vice Chair Wehrenberg, Commissioners Biddle, King, and Tomlinson;
Mary Jo Wilson, Planning Manager; Mamie Nuccio, Associate Planer; and Rhonda Franklin,
Recording Secretary.
Absent: None
ADDITIONS OR REVISIONS TO THE AGENDA - NONE
MINUTES OF PREVIOUS MEETINGS
The April 24, 2007 minutes were approved as submitted.
ORAL COMMUNICATIONS - NONE
CONSENT CALENDAR - NONE
WRITTEN COMMUNICATIONS - NONE
PUBLIC HEARINGS
8.1 Continuation of P A 06-026 Dublin Gateway Medical Center Building 3 Hospital and Garage -
Planned Development Rezone and Stage 1 and 2 Development Plan, Conditional Use Permit,
Site Development Review and Development Agreement (Adjudicatory and Legislative
Actions).
Chair Schaub stated that the Planning Commission is being asked to approve an application for
a hospital, but is being provided project plans that title the project as a Medical Office Building.
Chair Schaub asked for the Staff Report.
Ms. Mamie Nuccio, Associate Planner, presented the specifics of the project as outlined in the
Staff Report.
Chair Schaub asked if any parking spaces were removed as a result of the relocation of the trash
enclosures, and Ms. Nuccio stated that no parking spaces were removed.
Chair Schaub pointed out that the excess of 84 parking stalls includes 17 motorcycle stalls.
iPfanning CommUJ"ion
fJ(f;[fltlar'Meetil1{j
47
'May 8, 2007
Attachment 6
DRAFT
!!If 1 /~]./
DRAFT
Chair Schaub sought clarification on the two construction options that would be granted to the
Applicant should the project be approved. Ms. Nuccio explained that the Applicant could
either construct a 3-story, 58,000 square foot medical office building with a 4-level parking
garage; or a 6-story, 100-bed hospital building with a 5-level parking garage.
Chair Schaub sought clarification that a project approval would only allow a 6-story hospital
building to be built, and not a 6-story medical office building, even though the plans indicate
that the 6-story building is a medical office building. Ms. Nuccio explained that although the
project plans label the building as a medical office building, all of the approval documentation,
including the Development Plan, specifies that if the 6-story building is constructed, it can only
be used as a hospital building. If the Developer decides to not use the"'6-story building as a
hospital building, the Developer would have to apply for a Planned Development Rezone and
amend the Development Plan accordingly.
Chair Schaub sought clarification that if the hospital building is constructed, would the project
return to the Planning Commission with applications for the necessary amenities required for a
hospital. He pointed out that the Planning Commission would have the authority to approve or
deny the application at that time. Ms. Mary Jo Wilson, Planning Manager, explained that if the
Applicant could install the amenities within the existing design of the building, the application
may not need to return to the Planning Commission for review.
Vice Chair Wehrenberg asked if the requirement of a Central Utility Plan would require the
project to return to the Planning Commission for review. Ms. Wilson explained that the
construction of a Central Utility Plan in a separate building is not a part of the Applicant's
Planned Development Plan before the City at this time; therefore, an amended project could be
subject to additional City review.
Cm. Biddle asked about the review process of the State of California Office of Statewide Health
Planning and Development (OSHPD). He expressed concern that the 100-bed configuration of
the building could change based on OSHPD's review process. Ms. Nuccio explained that if the
number of beds increases, the project would have to return to the City for review because all of
the analysis on the project was based on a maximum of 100 beds. Chair Schaub stated that if
there were less beds and more office use, there would be parking issues. Ms. Nuccio explained
that the entire building must be used for hospital functions. She further stated that if portions
of the hospital were converted for other uses, the project would have to return to the City for
reVIew.
Cm. Tomlinson asked about the anticipated size of trucks that would be trafficking the loading
zone. Ms. Nuccio explained that the Applicant anticipates that the vast majority of deliveries
would be made by bobtail trucks, with occasional semi trucks. She further explained that the
loading zone was designed to accommodate semi trucks.
Vice Chair Wehrenberg stated that she would like to add to the Initial Study that if generators
or other noise generating sources are used, the project be brought back to the City for additional
review. Ms. Nuccio explained that because generators are not part of the current application,
the potential noise impact of generators was not analyzed as part of the Environmental Review.
cp[anning Commission
rJ?!;guIar'Meeti1l{j
48
'May 8,2007
DRAFT
I J51 J2.--'2/
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She further explained that if the Applicant identifies the need for generators on the site plan,
Staff would conduct a noise analysis and, if necessary, require the Applicant to attenuate
impacts accordingly. If the Applicant can not attenuate impacts accordingly, then Staff would
conduct additional environmental review and the project would return to the Planning
Commission. Vice Chair Wehrenberg added that she would like to add the potential use of
helicopters to the Initial Study as well.
Cm. King expressed concern about whether the correct direction for trucks entering the loading
zone would be obvious. Ms. Nuccio stated that signage can be installed at the entrance of the
loading zone to guide the drivers. Cm. Tomlinson pointed out that most deliveries would
probably be from the same companies, thus the drivers would gain familiarity with the
navigation of the loading zone. Chair Schaub pointed out that the entrance to the loading zone
is in the area of the egress for the Ulferts Shopping Center. He stated that to reduce the load on
Glynnis Rose Drive, signage could easily be added to the Ulferts parking lot to direct consumers
to exit in a different direction.
Chair Schaub opened the public hearing.
Mr. Rick Needham, with Triad Partners, spoke if favor of the project on behalf of the Applicant.
Chair Schaub asked for Planning Commission feedback on the architectural changes to the
building. The Planning Commissioners stated that they are pleased with the improvements.
Chair asked for Planning Commission feedback on the changes to the loading zone. Cm. Biddle
asked for clarification on truck routes into the loading zone. Staff explained that from Dublin
Boulevard, trucks should take Tassajara Road, to Koll Center Drive, to Glynnis Rose Drive to
the loading zone. From the 1-580 Tassajara ramps, trucks should take Koll Center Drive to
Glynnis Rose Drive to the loading zone. Vice Chair Wehrenberg asked if signage for truck
traffic would be addressed. Ms. Wilson explained that signage for truck traffic would be
addressed as part of the Master Sign Program.
Cm. King expressed concern about whether there would be enough space for forward
movement in order for trucks to back out appropriately. Mr. Jim Terry, with Ware Malcolmb
Architects, stated that the turning radius for the loading zone was designed for larger trucks;
however, smaller trucks would most often frequent the loading zone. Mr. Needham stated that
the larger trucks would typically arrive at the loading zone in the early morning.
Chair Schaub asked about the quantity of truck deliveries per week. Ms. Cynthia Lee, Health
Care Consultant, spoke in favor of the project on behalf of the Applicant. She stated that she
contacted several comparable institutions to get an estimate of the number of deliveries per
week. She stated that it is anticipated that 10-12 deliveries would be made per week. Vice
Chair Wehrenberg asked if this number included food deliveries, and Ms. Lee said yes.
Chair Schaub stated that without a cafeteria in the building, finished foods would also need to
be delivered. Ms. Lee clarified that it is anticipated that the building would have a cafeteria,
and thus would not need finished food deliveries.
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Vice Chair Wehrenberg pointed out that the project plans for the hospital are missing key
elements such as an operating room, cafeteria, and pharmacy. She asked if the project plans
would change based on the needs of the tenant. Mr. Joseph Carroll, Applicant, spoke in favor of
the project. He explained that the Development Team, knowing that the tenants would come at
a later date, created project plans that depicted the most important factors of the project such as
the bed count, circulation, the emergency department, and the loading zone. He stated that the
Development Team did not want to propose project plans to the Planning Commission that
would ultimately change based on the specific needs of a tenant.
Mr. Carroll reiterated that the loading zone was sized for an IS-wheel semi truck; although
bobtail trucks would frequent the loading zone 90% of the time. Cm. Biddle pointed out that a
positive feature of the loading zone is that the area is large enough to accommodate two trucks.
Cm. King asked about the view of the loading zone from Glynnis Rose Drive, and Mr. Carroll
stated that it would look like the sides of building. Ms. Nuccio added that the loading zone
was designed to accommodate two trucks. She also stated that the Conditions of Approval
(COAs) were revised to include that should any activities related to the loading zone become a
problem, the Applicant would be required to provide a plan that outlines loading zone activities
subject to approval by the City.
Chair Schaub stated that this loading zone is significant because it is located near a busy street;
whereas most loading zones are not.
Vice Chair Wehrenberg confirmed that the Applicant would locate a tenant before going too far
with the project, and Mr. Carroll said yes. Vice Chair Wehrenberg pointed out that the loading
zone would generate a lot of trash and that medical waste would need to be addressed as well.
Chair Schaub asked for Planning Commission feedback on the changes to the trash enclosures.
The Planning Commissioners stated that it is a big improvement. Cm. Biddle pointed out that,
if necessary, it would be easy to enlarge the trash enclosures in this location.
Cm. Biddle asked how hazardous waste would be handled. Ms. Lee stated that hazardous
waste is typically disposed of in locked containers near the loading zone and is handled
separately from regular trash.
Chair Schaub asked for Planning Commission feedback on the changes to the parking structure.
The Planning Commissioners stated that they are happy with the changes. Cm. Biddle
expressed concern with the disparity of parking spaces allotted to the medical offices as
opposed to the hospital. Mr. Carroll explained that the shared parking arrangement would
provide for adequate parking.
Vice Chair Wehrenberg pointed out that afternoon shift changes could potentially strain
parking availability. Mr. Carroll stated that the demand for parking generally tails off in the
afternoon. Vice Chair Wehrenberg asked about the potential to modify the parking based on
the needs of future tenants. Mr. Carroll stated that it is anticipated that the current parking
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would handle the needs of future tenants. Vice Chair Wehrenberg stated that in regard to the
motorcycle spaces, there would probably be little demand for motorcycle parking at a hospital.
Vice Chair Wehrenberg asked if they have had to display signage to distinguish employee
parking from patient parking. Mr. Carroll stated that they designate parking spaces for
employees and patients. Vice Chair Wehrenberg expressed concerned about parking
overflowing into the Ulferts Shopping Center. Cm. Tomlinson stated that he is comfortable
with the number of parking spaces at the project. He stated that his concern is that patrons from
the shopping center might overflow into the project's parking areas.
Vice Chair Wehrenberg asked if the Applicant would be allowed to add another level to the
parking garage if parking spaces were eliminated due to the placement of mechanical
equipment. Ms. Nuccio stated that in such a case, the Applicant would need to apply for an
amendment to the Site Development Review.
Cm. Biddle asked if the parking structure would be built before the hospital. Mr. Carroll stated
that it is required that the parking structure be built before the hospital.
Cm. King stated that he is concerned about the idea that the form of the building is following
the function, instead of function following form. He asked if it is typical for a building shell to
be constructed before tenants are identified. He further stated that he is concerned the future
tenants might want to change the building to suit their needs. Mr. Carroll explained that the
room plan was the critical factor in ensuring that the building would be compatible with the
needs of potential tenants.
Chair Schaub asked Mr. Carroll if he has built a hospital before, and Mr. Carroll said no. Vice
Chair Wehrenberg expressed concerns that the OSHPD review process may require
architectural changes to the building. Mr. Carroll stated that he does not think this will be the
case; however, if changes are necessary, they would revisit the plans.
Cm. Biddle expressed concern that double-occupancy rooms would be more desirable to future
tenants instead of single occupancy rooms. Mr. Carroll stated that he believes that single
occupancy rooms are more desirable. Vice Chair Wehrenberg added that patient satisfaction is
higher in single occupancy rooms.
Cm. Biddle expressed concern with whether various medical specialties would be able to
function in the IOO-bed configuration of the building. He questioned whether the facility could
accommodate amenities such as food service operations, pharmacy, operating room, morgue,
etc. Mr. Needham explained that the Development Team modeled and tested three specific
design plans for the building and all of the design plans were functional. Mr. Carroll explained
that the Development Team has worked with consultants in the hospital field that have advised
them that the current design is functional and would work with various tenants.
Cm. Biddle asked about the process of finding a tenant. Mr. Carroll stated the he is currently
talking with potential tenants. Cm. Biddle asked about the timeframe for completing the
building, and Mr. Carroll stated that it could take 3-5 years.
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Vice Chair Wehrenberg suggested that the Applicant submit plans to the City before submitting
them to OSHPD to help alleviate potential issues. Mr. Carroll stated that he would work with
the City during the design development.
Chair Schaub asked about the Conditions, Covenants, and Restrictions (CCRs). Ms. Nuccio
explained that the CCRs are in place to govern the relationship between the 4 parcels on the site.
Mr. Gary Sloan, San Ramon Medical Center Chief Executive Officer, expressed concern about
the impacts a new hospital could have on existing hospitals, as well as police and fire protection
services, within the Tri-Valley. Mr. Sloan stated that the Planning Commission did not have
enough information regarding the project to make an informed decision. He stated that the
Planning Commission should know who the tenant will be before making a decision on the
project.
Cm. Biddle asked about the differences in hospital types and the associated impacts on parking,
traffic, etc. Mr. Sloan gave several examples of various hospitals and their associated impacts.
Chair Schaub closed the public hearing.
Cm. Tomlinson stated that the project is worthy of support. He stated that the Applicant was
responsive to the Planning Commission's concerns and recommendations. He further stated
that he is satisfied with the amount of parking at the project, as well as Staff's research on
parking at comparable facilities. He stated that the neighboring buildings are adequately
parked per the Dublin Zoning Ordinance. He stated that the Conditions of Approval are
appropriate and sufficient for the project and that it is the responsibility of the Applicant to find
a tenant that can function within the approved project.
Vice Chair Wehrenberg stated that the project is lacking the infrastructure needed to support a
potential tenant. She asked if the project would return to the Planning Commission if the
parking was impacted by future changes. Ms. Wilson explained that the Site Development
Review (SDR) Findings are based on the current design of the site, including surface parking
and access; therefore, if the site design changes, amended plans would have to be resubmitted
and reviewed by the City.
Vice Chair Wehrenberg stated that COA No. 18 should also require that loading dock activities
be reviewed when a tenant is identified and prior to any plan submittals. Ms. Wilson suggested
that the additional language be included as a part of COA No. 22.
Vice Chair Wehrenberg expressed concern about screening oxygen tanks and stated that the
potential use of oxygen tanks should be identified as early as possible. Chair Schaub added that
the potential use of generators should also be identified as early as possible. Ms. Wilson
suggested that those concerns be addressed in COA No. 22. She further stated that the addition
of an oxygen tank and/ or generator to the plans could trigger additional review from the City.
Vice Chair Wehrenberg suggested that the Fire Department COAs include a review of the
hazardous materials plans. She pointed out that the City will own the building once OSHPD
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finals the building. Ms. Wilson suggested that the additional language be included as a part of
COA No. 22.
Vice Chair Wehrenberg suggested that the tenant be required to provide a staffing plan to
confirm that the parking is adequate. Ms. Wilson stated that the condition can be added to the
COAs.
Chair Schaub reiterated that this project has a lot of open-ended issues. Vice Chair Wehrenberg
stated that she does not feel that 3 acres is conducive for a hospitals site, including the parking
garage.
Vice Chair Wehrenberg suggested that a condition be added that requires any plans for
helicopters and associated facilities be submitted to the City. Ms. Wilson stated that under
CEQA, plans for a helicopter and associated facilities would have to be reviewed and analyzed.
She stated that the application for the project indicates that there will not be a helicopter or
associated facilities for the project.
Cm. Biddle asked if the tenant would have to submit plans to the City each time plans are
submitted to OSHPD. Ms. Nuccio explained that the requirement is currently in the COAs.
Cm. Biddle stated that in general, he likes the concept of having a hospital in the City and he
likes the architecture of the building. He stated he feels a little more comfortable with the
project.
Vice Chair Wehrenberg asked if the COAs could be attached to the tenant's lease agreement.
Ms. Wilson stated that such a request could be asked of the Applicant. Ms. Wilson pointed out
that there are multiple points in the process where Staff would notify the tenant of the COAs for
the project. Cm. Tomlinson also pointed out that COA No. 15 seems to be a broad lever in
which to ensure the project remains consistent with the COAs. Mr. Carroll stated that he would
comply with the Planning Commission's request to attach the COAs to future tenants' lease
agreement.
Cm. King stated that he likes the design of the project.
Chair Schaub stated that he likes the project. He stated that it is important to get the project
finished they way the project is approved. He pointed out that COA No. 15 establishes that the
project is subject to annual review. He stated that he does not want the project to be put in
jeopardy because of significant infrastructure problems.
The Planning Commission complemented Staff on the work done on this project. The Planning
Commission also thanked the Development Team members for their work on the project.
Vice Chair Wehrenberg stated that the project plans should be labeled Hospital and not Medical
Office Building.
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Ms. Wilson confirmed that the Applicant, Mr. Carroll, concurs with the amendments to the
COAs.
On a motion by Cm. Biddle, seconded by Cm. Tomlinson, with a suggestion to amend the
Resolution of the City Council Approving a Conditional Use Permit and Site Development
Review to amend Condition of Approval No. 22 to include: "The Applicant shall also submit a
hazardous materials plan and a typical schedule of loading dock activities including types of deliveries,
number of deliveries, and types of vehicles."; and with a suggestion to add Condition of Approval
No. 22A to read: "Prior to the issuance of a building permit for the parking garage, the Applicant shall
provide the City with a written statement identifying the hospital tenant and the specific staffing levels
with respect to the number of doctors and employees on the largest shift. If the numbers of doctors or
employees on the largest shift increases, a parking analysis shall be conducted to ensure that adequate
parking will be provided in accordance with the Zoning Ordinance. If additional parking is needed, the
Applicant shall apply for an amendment to the Conditional Use Permit and Site Development Review
and such application shall be reviewed and approved prior to the issuance of a grading or building permit
for the parking garage."; and with a suggestion to add Condition of Approval No. 26A to read:
'The Developer shall provide a copy of the approved Conditions of Approval to all future tenants.", and
by a vote of 5-0-0, the Planning Commission unanimously adopted:
RESOLUTION NO. 07 - 23
A RESOLUTION OF THE PLANNING COMMISSION
OF THE CITY OF DUBLIN
RECOMMENDING THAT THE CITY COUNCIL ADOPT A CEQA ADDENDUM FOR AN
AMENDMENT TO THE STAGE 1 AND STAGE 2 DEVELOPMENT PLAN FOR PLANNED
DEVELOPMENT ZONING DISTRICT (PA 98-047) AND FOR A CONDITIONAL USE PERMIT
AND SITE DEVELOPMENT REVIEW FOR THE DUBLIN GA TEW A Y MEDICAL
CENTER BUILDING 3 HOSPITAL AND GARAGE PROJECT
LOCATED AT 4100 AND 4084 DUBLIN BOULEVARD
APN 986-0016-021 & 986-0016-022
P A 06-026
RESOLUTION NO. 07 - 24
A RESOLUTION OF THE PLANNING COMMISSION
OF THE CITY OF DUBLIN
RECOMMENDING CITY COUNCIL ADOPTION OF A PLANNED DEVELOPMENT REZONE
AND STAGE 1 AND 2 DEVELOPMENT PLAN FOR THE DUBLIN GA TEW A Y MEDICAL
CENTER BUILDING 3 HOSPITAL AND GARAGE PROJECT LOCATED AT 4084 AND 4100
DUBLIN BOULEVARD
APN 986-0016-021 & 986-0016-022
P A 06-026
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RESOLUTION NO. 07 - 25
A RESOLUTION OF THE PLANNING COMMISSION
OF THE CITY OF DUBLIN
REFERRING DECISION MAKING AUTHORITY AND RECOMMENDING CITY
COUNCIL APPROVAL OF A CONDITIONAL USE PERMIT AND SITE DEVELOPMENT
REVIEW FOR THE DUBLIN GATEWAY MEDICAL CENTER BUILDING 3 HOSPTIAL
AND GARAGE PROJECT LOCATED AT 4084 AND 4100 DUBLIN BOULEVARD
APN 986-0016-021 & 986-0016-022
P A 06-026
RESOLUTION NO. 07 - 26
A RESOLUTION OF THE PLANNING COMMISSION
OF THE CITY OF DUBLIN
RECOMMENDING CITY COUNCIL APPROVAL OF A DEVELOPMENT AGREEMENT
FOR THE DUBLIN GATEWAY MEDICAL CENTER BUILDING 3 HOSPITAL AND
GARAGE PROJECT LOCATED AT 4084 AND 4100 DUBLIN BOULEVARD
APN 986-0016-021 & 986-0016-022
P A 06-026
NEW OR UNFINISHED BUSINESS - NONE
OTHER BUSINESS
Cm. Tomlinson informed the Planning Commission and Staff that he would be on vacation
during the August 14,2007 Planning Commission meeting.
Cm. King stated that if the Planning Commission is going to discuss projects that impact Dublin
Boulevard, he would like to know the City's position with regard to regional transportation
planning. Ms. Wilson stated that she would research the issue.
10.1 Brief INFORMATION ONLY reports from the Planning Commission and/or Staff,
including Committee Reports and Reports by the Planning Commission related to
meetings attended at City Expense (AB 1234).
The Planning Commission did not have any items to report.
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ADJOURNMENT - The meeting was adjourned at 9:00 p.m.
Respectfully submitted,
Planning Commission Chair
AITEST:
Planning Manager
iPfanning Cormnis.l'wn
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