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Home My WebLink About1756 BLACKBIRD CIR; ; CBR2023-4115; Recycle{_ City of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN 8-59 Development Services Building Division 1635 Faraday Avenue www.carlsbadca.gov This form shall be completed for all demolitions and new construction, additions, and alterations. The California's Green Building Standards Code (CALGreen) requires that at least 65% of construction site debris generated during demolition projects, most new construction, as well as the majority of building additions or alterations be recycled, reused, or otherwise diverted from landfill disposal. STEP 1: The Applicant must submit PART 1 of this form before a building permit application is approved. STEP 2: The permit holder shall utilize a waste management company that can provide verifiable documentat ion t hat meets 65% waste diversion. Republic Services is the exclusive franchised waste hauler in the City of Carlsbad. • Option A-Roll-Off Bins: Call Customer Service (760) 332-6464 and ask for a C&D account for waste diversion. Republic Services will provide roll-off bins for construction waste. • Option B -Se lf Hau l to Republic Services or other dump site that can provide verifiable documentation. It must be a Certified Source Separated Recycling Facility. When you enter the site, explain to gate operator that this is C&D material. When you exit the site, request a receipt and certificate from gate operator for waste diversion. STEP 3: Prior to permit close-out (permit final), the permit holder shall complete PART 2 of this form and submit all trash and recycling weight receipts to the building inspector. Waste log, acknowledgement, and tickets must be submitted to release your certificate of occupancy. APPLICANT CERTIFICATIONS: CHECK EACH BOX 1Z] I certify under penalty of perjury under the laws of the State of California that the information provided in and with this form pertains to construction and demolition debris generated only from the project listed in PART 1, that I have reviewed the accuracy of the information, and that the information is true and correct to the best of my knowledge and belief. 1Z] I understand the waste diversion requirements of the State of California and submit this Construction Waste Management Plan pursuant to California Green Building Standards Code 4.408.2 or 5.408.1.1. Failure to provide documentat ion of C&D reporting, reporting of waste diversion less than 65%, and failure to provide adequate weight receipts, may result in enforcement action against me or other responsible parties, including a notice of violation, citations, and any other remedies provided in Chapters 1.08 and 1.10 of the Carlsbad Municipal Code. Projects are required to submit their Waste Log, Acknowledgement Form, and Weight Receipts prior to Certificate of Occupancy (CO) issuance. 1Z] This project does not involve disposal of universal or hazardous waste OR this project includes disposal of universal or hazardous waste in a responsible, safe and verifiable manner. Disposal of asbestos- containing materials, batteries, electronic waste, fluorescent bulbs, lead based paints, mercury containing equipment and refrigerants, require special processing prior to commencement of Date: 11 /26/24 Page 1 of 4 rev 4/24 PART 2. Complete and submit this form before final inspection. Projects are required to submit their Waste Log, Acknowledgement Form, and Weight Receipts prior to Certificate of Occupancy (CO) issuance. Failure to provide documentation, reporting of waste diversion less than 65%, and failure to provide adequate weight receipts, may render the Project non-compliant and the responsible parties subject to code enforcement. SECTION A Permit No. "]; Project Title Project Address J 16$ 13~\{g> &\ f< APN Applicant Name _______________________ Phone Last First Use this Final Log below to track loads of materials as they leave the job site. @@SAVE RECEIPTS @@ Indicate FINAL quantities in tons for each material and save receipts and documents from facilities where material is taken. Additional Project Log pages are available if necessary. Use City Conversion Table to convert volume to tons. A B C Date Example: 01/01/2020 Material Type Concrete (broken) ®TOTAL Actual Amt Reused or Salvaged 0 Actual Amt Recycled 5 tons 0 Actual Amt Disposed in Landfill 0 Destination Facility (Name, Address, Phone) Palomar Transfer Station, 5960 El Camino Real -(760 603-0153 Diversion Rate Achieved _'2~. ~~___,! _ __._._2__._..< ___ =_,.:...__% 2: 65% Total of columns A + B Total of columns A + B + C DIVERSION Attach the following documentation to this Report: • Original recycling weight tickets, landfill weight tickets • Original donation receipts with photos and/or itemized descriptions • Any other relevant information to support Recycling Report SECTION D Return completed form and documentation to: City of Carlsbad Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 I certify under penalty of perjury under t he laws of the St ate of California that the information provided in and with this form pertains to co nst ruction and demolition debris generated only from the project listed in PART 1, that I have reviewed t he accuracy of the information, and that the information is true and correct to t he best of my knowledge and belief. Applkant s;gnature~~ Date 17)~/ 2 ~J ( Page 3 of 4 rev 4/24 CONVERSION TABLE FOR COMMON CONTRUCTION WASTE. This document is informational only and may be used to convert truckload quantities to tons. Column A Column B Column C Category Material Volume Tons[Unit Tons Mixed Debris Construction cy X 0.18 = Demolition cy X 1.19 = Asphalt/Concrete Asphalt (broken) cy X 0.70 = Concrete (broken) cy X 1.20 = Concrete (solid slab) cy X 1.30 = Brick/Masonry/Tile Brick (broken) cy X 0.70 = Brick (whole, palletized) cy X 1.51 = Masonry brick (broken) cy X 0.60 = Tile sq ft Building Materials (cabinets, doors, windows, etc.) X cy 0.00175 = Cardboard (f lat) cy X 0.15 = Carpet By square foot sq ft X 0.05 = By cubic yard cy X 0.0005 = Carpet Padding/Foam sq ft X 0.30 = Ceiling Tiles Whole (palletized) cy X 0.000125 = Loose cy X 0.0003 = Drywall (new or used) 1/2" (by square foot) sq ft 5/8" (by square foot) sq ft X 0.09 = Demo/used (by cu. yd.) cy X 0.0008 = Landscape Debris (brush, trees, etc.) cy X 0.00105 = Asphalt Composit ion X 0.25 Shingles, asphalt Shingle = cy Unpainted Wood/Pallets By board foot bd ft X 0.15 = By cubic yard cy X 0.22 = Trash/Garbage cy X 0.001375 = Other (estimated weight) cy X 0.15 = cy cy X 0.18 = cy X estimate = Total ALL = 0 Page 4 of 4 rev 4/24 PART 1 Complete and submit this form when applying for a building permit. Permits will not be issued without a completed Construction Waste Management Plan. • . Permit No . CBR2023-4115 Project Title Cotner Remodel Project Address 1756 BLACKBIRD CIR APN Applicant Name Blasio, Alena Phone 760-729-3965 Last First --Complete the following table with estimated waste tonnage to be generated by your project. A B C Material Type Estimat ed Place a (✓) check Place a ( ✓) check next Place a(✓) check next Waste Quantity next to items to be to items to be to items to be (tons) reused or salvaged recycled disposed at landfill Complete this line of the table only if only using WASTE MANAGEMENT □ □ □ roll-off bins. Mixed C&D Debris Asphalt & Concrete □ □ □ Brick/ Masonry/ Tile □ □ □ Mixed Inert Debris □ □ □ Cabinets, Doors, Fixtures, □ □ □ Windows (circle all that apply) Carpet □ □ □ Carpet Padding/ Foam □ □ □ Cardboard □ □ □ Ceiling Tile (acoustic) □ □ □ Drywall (used, new, scrap) □ □ □ Landscape Debris (brush, trees, □ □ □ stumps, etc.) No dirt. Unpainted Wood & Pallets □ □ □ Roofing Materials □ □ □ Scrap Metal □ □ □ Stucco □ □ □ Other: □ □ □ TOTAL 0 _,,. .... To meet 65% Diversion Requirement (estimate) X 0.65 = tons Total Estimated Waste from above Minimum Required Diversion A I. [Z] s· pp ,cant 1gnature Date Page 2of4 rev 4/24 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD , CA 92008 (760)603-0153 018616 -B .A WORTHING , INC 5145 AVENIDA ENCINAS STE#I CARLSBAD , CA 92008 Contract: COMM-GATE GROSS TARE NET Tracking Qty : Yr . 200 6 ,520 4,660 1,860 0 .00 Qty Unit Description 0.93 TN MSW Origi n : CARLSBAD Signature: Scale I n Tare Out 100% 54 Ticket #: 2655276 Weighmaster : marticy In: Out : Vehicle : Ref: BOL: INBOUND INVOICE February 01, 2024 February 01 , 2024 a105310 Rate Extension Tax $0 .00 $96 . 28 $89 .54 Total Paid Change 12:48 pm 12:48 pm Total $89.54 $89.54 $0 .00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract: COMM-GATE Yr. 200 GROSS 6,040 Scale In TARE NET 4,700 Tare Out 1 ,340 Tracking Qty: 0.00 Qty Unit Description 0.67 TN MSW Origin : CARLSBAD 100% Signature : '.:i<I Ticket #: 2709801 Weighmaster: marticy In: June 19, 2024 Out : June 19, 2024 Vehicle: a105310 Ref: BOL : I NBOUND INVOICE Rate Extension $101. 2] $67 . 81 Tax $0.00 Total Paid Change 9: 18 am 9: 18 am Total $67 .81 $ 67 . 81 $0 .00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING , INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract: COMM-GATE Yr . 200 GROSS 5,800 TARE 4,660 NET Tracking Qty: 1,140 0 .00 Qty 0 .57 Unit Description TN MSW Origin: CARLSBAD Signature: l'i :1 Ticket #: 2662855 Weighmaster: marticy Scale In Tare Ou t 100% In: Out: Vehicle: Ref: BOL : INBOUND INVOICE February 22 , 2024 February 22 , 2024 al05310 Rate Extension $96 .28 $55.00 Tax $0.00 Total Paid Change 1:51 pm 1 :51 pm Total $55.00 $55 .00 $0 .00 $0.00 PALOMAR TRANSFER 5960 EL CAMINO REAL C~RLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING , INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract: COMM-GATE Yr. 200 GROSS 5,260 Scale In TARE 4,660 Tare Out NET 600 Tracking Qty: 0.00 Qty Unit Description 0.30 TN MSW Origin: CARLSBAD 100% ' •\. ♦ -•• .-·~-, :)4 Ticket #: 2658006 Weighmaster: marticy In: February 09, 2024 Out: February 09, 2024 Vehicle: a105310 Ref: BOL: INBOUND INVOICE Rate Extension $96. 28 $55 .00 Tax $0 .00 ,/ .~.f"O _____ ,., .. _.,.._,,-..__ s igna ture : 1 _;._..,...,(=;__.0..__"l_'_Y\P...__.._· _::::y::-:-:_.__--~--'------------7 Total Paid Change '-,_____..-~· 2:59 pm 2:59 pm Total $55.00 $55.00 $0.00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD , CA 92008 Contract: COMM-GATE Yr. 200 GROSS 5 ,960 Scale In TARE 4, 660 Tare Out NET 1,300 Tracking Qty : 0.00 Qty 0 .65 Unit Description TN MSW Origin : CARLSBAD Signature: 100% 54 Ticket #: 2655542 Weighmaster: perezj26 In: Out : Vehicle: Ref : BOL : INBOUND INVOICE February 02, 2024 February 02, 2024 al05310 Rate Extension $96 .28 $62 .58 Tax $0.00 Total Paid Change 10: 30 am 10 :30 am Total $62.58 $62 .58 $0.00 $0.00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING , INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract : COMM-GATE Yr. 200 GROSS 6 ,040 TARE 4 ,700 NET Tracking Qty: 1 ,340 0.00 Qty Unit Description 0. 67 TN MSW Origin: CARLSBAD Scale I n Tare Out 100% 54 Ticket#: 2757586 Wei ghmaster: aceveos In: October 09, 2024 Out: October 09, 2024 Vehicle: al05310 Ref: BOL : INBOUND INVOICE Rate Extension $101. 2] $67. 81 Tax $0.00 Signature: fr2C s v-.___ c~-· ~•.zZ~/2) Total Paid Change 7:47 am 7:47 am Total $67.81 $ 67. 81 $0 .00 $0 .00 PALOMAR TRANSFER 760-603-0153 REPRINT 5960 EL CAMINO REAL CARLSBI\D, CA 92008 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#! CARLSBAD, CA 92006 Contract:COMM-GATE Yr. 2007 0.00 0.99 Scale In GROSS WEIGHT Tare Out TARE WEIGHT YD Tracking QTY tn MSW 6, 680 NET TONS 4,700 NET WEIGHT Origin:CARLSBAD 100\ 54 0.99 1,980 2745498 Cynthia M. 9/11/24 10:17 nm a 105310 $101.21 $100. 20 CHA.'IGE: CHE:CK : 9/11/24 10:17 am INBOUND INVOICE $0.00 $100.20 $100.20 S0.00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#! CARLSBAD, CA 92008 Contract: COMM-GATE Yr. 200 GROSS 5,600 TARE NET Tracking Qty: 4,700 900 0.00 Qty 0. 4 5 Unit Description TN MSW Origin: CARLSBAD Signature: :=,.-1 Ticket #: 2753676 Weighmaster : marticy Scale In Tare Out 100% In: September 30, 2024 Out: September 30 , 2024 Vehicle: a105310 Ref: BOL: INBOUND INVOICE Rate Extension $101. 2] $58.00 Tax $0.00 Total Paid Change 9 :34 am 9:34 am Total $58 .00 $58.00 $0.00 $0.00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760) 603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD , CA 92008 Contract: COMM-GATE Yr. 200 GROSS 6 ,440 Scale In TARE 4, 700 Tare Out NET 1,740 Tracking Qty : 0 .00 Qty Unit Descript ion 0.87 TN MSW Origin: CARLSBAD 100% Signature: 5.1 Ticket #: 2698207 We i ghmaster: cisneadl In: May 21, 2024 Out : May 21 , 2024 Vehicle : a105310 Ref : 801 : INBOUND I NVOICE Rate Extension $96.28 $83 .76 Tax S0 .00 Total Paid Change 1:39 pm 1 :39 pm Total $83.76 $83.76 $0.00 $0.00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 ( 7 60) 603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS ST E#I CARLS BAD, CA 92008 Contract : COMM-GATE Yr. 200 GROSS 5 ,200 Scale In TARE 4, 700 Tare Out NET 500 Tracking Qty: 0.00 Qty 0.25 Unit Description TN MSW 54 Ticket #: 2716008 Weighmaster : marticy In ; Ju 1 y 0 3 , 2 0 2 4 Out: July 03, 2024 Vehicle : al05310 Ref : BOL: INBOUND INVOICE Rate Extension $101.2) $58 .00 Tax $0.00 Origin: CARLSBAD 100% $19.333/job Signature: Total Paid Change 12:42 pm 12 :42 pm Total S58 .00 $58.00 $0 .00 $0.00 PALOMAR TRANS FER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract : COMM-GATE Yr . 200 GROSS 6,040 Scale In TARE 4, 660 Tare Out NET 1 ,380 Tracking Qty : 0.00 Qty Unit Descri ption 0 .69 TN MSW 54 Ticket II': 2670151 Weighmaster: martios3 In: March 12 , 2024 Out: March 12, 2024 Vehi cle: al05310 Ref: BOL : INBOUND INVOICE Rate Extension $96.28 $66.43 Tax $0.00 Origin: CARLSBAD 100% Cotner $22.14 Signature: /\ Co r t1.ilf"} Total Paid Change 3:08 pm 3:08 pm Total $66.43 $66.43 $0 .00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760) 603-01:)3 018616 -B.A WORTHING, I NC 5145 AVENIDA ENCINAS STE#! CARLSBAD, CA 92008 Contract: COMM-GATE Yr. 200 GROSS 5,580 TARE NET Tracking Qty: 4,660 920 0 .00 Qty Onit Description 0 .46 TN MSW Origin: CARLSBAD $27. 50 each Signature : '.,,1 Ticket #: 2669872 Weighmaster: martios3 Scale In Tare Ou t 100% In: March 12, 2024 Out: March 12, 2024 Vehicle: al05310 Ref: BOL: INBOUND INVOICE Rate Ex tension $96.28 $55.00 Tax $0 .00 Total Paid Change 8 : 4 6 am 8 : 4 6 am Total $55.00 S55.00 $0 .00 $0.00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760) 603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract : COMM-GATE Yr. 200 GROSS 6 ,400 TARE 4,700 NET Tracking Qty : 1 ,700 0 .00 Qty 0 .85 Unit Descript ion TN MSW Origin: CARLSBAD $40. 92 each Signature : '>1 Ticket #: 2678710 Weighmaster: marticy Scale In Scale Out 100% In: April 03 , 2024 Out : April 03 , 2024 Vehicle: CD Ref : Tovota BOL: INBOUND INVOICE Rate Extension $96. 28 $81. 8 4 Tax $0 .00 Total Paid Change 11 : 44 am 12:08 pm Total $81 .84 $81 .84 $0 .00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIOA ENCINAS STE#I CARLSBAD, CA 92008 Contract : COMM-GATE Yr . 200 GROSS 7 ,940 Scale In TARE 4 ,660 Tare Out NET 3 ,280 Tracking Qty: 0 .00 Qty 1. 64 Unit Descri ption TN MSW 54 Ti cket It: 2664316 Weighmaster: marticy In: February 26, 2024 Out: February 26, 2024 Veh icle : al05310 Ref: 801: INBOUND INVOICE Rate Extension $96. 28 $157 . 90 Tax $0 .00 Origin : CARLSBAD 100% (Y\SiO Signat ure: Total Paid Change 3:26 pm 3 :26 pm Total $157.90 $157 .90 $0.00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract : COMM-GATE GROSS TARE NET Yr. 200 6,220 4,660 1,560 Scale In Tare Out Tracking Qty : 0 .00 Qty Unit Description 0. 78 TN MSW Origin: CARLSBAD 100% Signature : \ \ u , • • J ' ( 0 > (1J.,v C v ' 54 Ticket #:2667579 Weighmaster: gomezda I n : March 06, 2024 Out: March 06, 2024 Vehicle: al05310 Ref: BOL : INBOUND INVOICE Rate Extension $96.28 $75.10 Tax $0 .00 Total Paid Change 8:17 am 8:17 am Total $75 .10 $75.10 $0 .00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, INC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract: COMM-GATE Yr. 200 GROSS 6,220 Scale In TARE 4, 660 Tare Out NET 1,560 Tracking Qty: 0 .00 Qty 0.78 Unit Description TN MSW Origin: CARLSBAD 100 % 5•1 Ticket #:2667579 Weighmaster: gomezda In : March 06, 2024 Out : March 06, 2024 Vehicle: al05310 Ref: BOL : INBOUND INVOICE Rate Extension $96 .28 $75.10 Tax $0 .00 Total Paid Change 8 : 17 am 8:17 am Total $75.10 $75.10 $0 .00 $0 .00