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Home My WebLink About110 SYCAMORE AVE; ; CBR2023-1646; Recycle,. ('city of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Deve/opmenf_Services Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov APPLICABLE TO NEW CO NSTRUCTION, ALL RES IDENTIAL ADDITIONS AND ALTERATIONS AND CO MMERCIAL ADDITIONS AND ALTERATIONS OVER $200K. If you have questions about the recycling requirement or completing this form, please contact Republic Services at (760) 332-6464 a certified C&D recycler, or the Carlsbad Building Division at (442) 339-2700. Please note: Unless you are self-hauling, Republic Services or approved haulers must be used for all construction projects within the City of Carlsbad. PART 1 Complete and submit this form when applying for a Building Permit. Note: Permits will not be issued without a completed Construction Waste Management Plan. Applicant Information Permit No. ____________ Project Title Project Address.-1-,l ,-/__.6_,___3=4yKG="'c«utU<'/,LJ1 f:"'-"'Lt-t'....__.A~v'--e~-e.___ __________ .APN Applicant Name _,_M---',~✓'-------'f.}'-'---'Le.:=,..,x'--_______ □ CEr t~~r Last First 2 0¥-IZL-05( [!] 'C) tf/',~/b/<. Applicant Address /7 q 7 s·-&oq< PR1..1Jrt£11 /JI. J?cwtl)v: ll4 11 o(e9" /4-tu @.. 14'1 14 De: fl ,<#' / Iv Ii -c C/M Phone (7 tJ(j ) 39 0 --0007 E-mail Address Applicant Mailing Address (if different than project address) Project Type (check all that apply): R•r2r•I Brief Description P 11-r-c ti Commercial □ Public Building □ 4-f: t -Pf.A CG $rC/( C 0 Project Size __ ?i~lf'----3=--=0=--______ Estimated Cost of Project $_4-'4.c..' -"''CJ"'--k:_ _____________ _ (square footage) Please check the appropriate box: I plan on using REPUBLIC SERVICES roll-off bin(s) for all materials and will provide all receipts after construction. I plan on using a City Approved Hauler and will provide all receipts after construction. This is a proposed LEED certified project and I plan on separating materials on site in conjunction with Republic Acknowledgement: I certify under penalty of perjury un der the laws of the Stat e 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. Print Name ~t¼,t,1 <b.d ec/,y s;gnatu,e /P4oL g Date Page 1 of 3 Rev. 05122 PART 1 Complete, obtain signature, and submit this form when applying for a Building Permit. Note: Permits will (cont'd) not be issued without a completed Construction Waste Management Plan. DEBRIS RECYCLING ESTIMATE: -..,:r-i1111.,•• Permit No. ____________ Project Title <::Z\/ ,,,./1.,n ef/£" 14vt:: "r~c u --i Project Address //0 5'(Cl4 l?f (}/! C J1.V 6- Applicant Name fl<( /4-(.Q.'l':: Last First 1 APN '2 01/-/ {, I-CY/ Phone Complete the following table with estimated waste tonnage to be generated by your project. This is your plan for construction waste management. Changes can be made on the final recycle report. Material Type Complete this line of the toble 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 -- Goal: the diversion rate shall be 65% by weights of debris. A B C -- Estimated Waste Quantity (tons) Place a (0) check next to items to be reused or salvaged □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Place a (0) check next to items to be recycled □ □ □ □ □ □ n □ □ n □ □ □ □ n □ Place a (0) check next to items to be disposed at landfill □ □ □ □ □ □ n □ □ □ □ □ □ □ 1'J. □ To meet 65% Diversion Requirement (estimate) -~-~--=CJ_,;/_9...__ __ x 0.65 = _ ____,?:...__S"-'1'--._c.....;_r _._/....,..b.._s.1...:.· ,_tons ,/4 Total Estimated Waste from above Contractor /Owner Signature /l ///J, Jt ,,/; Date f..YV" •p / / Minimum Required Diversion Page 2 of4 Rev. 05122 Conversion Table for Common Construction Waste This document is informational onlv. It is here to helo vou convert truckload auantities to tons. if necessarv. Column A Column B Column C Category Material Volume TonsLUnit Tons Mixed Debris Construction )6 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 X 0.00175 = Building Materials (cabinets, doors, windows, etc.) cy X 0.15 = Cardboard (flat) cy X 0.05 = Carpet By square foot sq ft X 0.0005 = By cubic yard cy X 0.30 = Carpet Padding/Foam sq ft X 0.000125 = Ceiling Tiles Whole (palletized) cy X 0.0003 = Loose cy X 0.09 = Drywall (new or used) 1/2" (by square foot) sq ft X 0.0008 = 5/8" (by square foot) sq ft X 0.00105 = Demo/used (by cu. yd.) cy X 0.25 = Landscape Debris (brush, trees, etc.) cy X 0.15 = Asphalt Composition Shingles, asphalt Shingle cy X 0.22 = Unpainted Wood/Pallets By board foot bd ft X 0.001375 = By cubic yard cy X 0.15 = Trash/Garbage cy X 0.18 = Other (estimated weight) cy X estimate = cy X est imate = cy X estimate = cy X estimate = Total all = Page 3 of 3 Rev .. 05122