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HomeMy WebLinkAbout1740 KIRK PL; ; CBR2024-1759; Recycle( City of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-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 Appl icant must submit PART 1 of this form before a build ing permit application is approved. STEP 2: The perm it holder shall utilize a wa ste management company that can provide verifiable documentation that meets 65% waste diversion. Repub lic 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 -Self Haul 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. C&D CERTIFICATION: D 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. D 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 documentation 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 re sponsible 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 . D 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 Page 1 of4 Date : I D/ J.f/:,_.(I I 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. SECTION A Permit No. ___________ Project Title Project Address \ 7 b,p '? \ '?--Y..--Q ~ Applicant Name l,ec.oM P1e Last First Phone SECTION B Complete the following table with estimated waste tonnage to be generated by your project. Material Type 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 SECTION C Estimated Waste Quantity (tons) To meet 65% Diversion Requirement (estimate) A B C Place a(✓) check next to items to be reused or salvaged Place a ( ✓) check next to items to be recycled Place a ( ✓) check next to items to be disposed at landfill timated Waste from above Minimum Required Diversion Page 2 of 4 rev 4/24 , ,......... DEBRIS RECYCLING REPORT (ACTUAL): SECTION A Acknowledgement 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. Permit No. (Sil ,eozy ~ \1 S°\ Print Name Address l ~ \.i( () (J.I r ll-pl . SECTION B Use this Final Log below to track loads of materials as they leave the job site. (O)(O)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 Exam~= 01/01/2020 SECTION C Material Type Concrete (broken) @TOTAL Diversion Rate Achieved Actual Amt Reused or Salvaged +8 Actual Amt Recycled Stons (. :5d -J Actual Amt Disposed in Landfill 'l{t.-- Total~A+B+C - I ( ,. " ,. Destination Facility (Name, Address, Phone) Palomar Transfer Station, 5960 Ef Camino Reaf -760 603-0153 '' ' I ' • ' ' C" % <":65% DIVERSION Contractor/Owner Signature,.....;!~'.A./.lll~~~--------Date t. /'lo/ 2 r-r I Attach the following documen Return completed form and documentation to: • Original recycling weight tickets, landfill weight tickets City of Carlsbad • Original donation receipts with photos and/or itemized descriptions Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 • Any other relevant information to support Recyding Report ity of Carlsbad FEB 10 20255l_ BUILDING DIVISION ~ECORD COPY 54 Ticket J: 2806531 TRANSFER cAMINO REAL D, CA 92008 Weighmaster: IN -lopezse3 OUT -aceveo -CASH AND CHECK CUSTOMER Ci\ 92008 ct: RESI GROSS TARE NET Qty: -GATE Yr. 2 34,920 28,320 6,600 o.oo QtY 3.30 Onit Description TN MSW CARLSBAD Signature: Scale In scale Out 100% In~ February 12, 2025 3:24 pm Out: February 12, 2025 3:46 pm Vehicle: co Ref: 34,920//450CC BOL: INBOUND CASH Rate Extension $101. 2J $333. 99 Tax $0.00 Total $333.99 Total Paid Change .EDIT CARD-SCALE $333.99 $333.99 $0.00 V R TRANSFER L CAMINO REAL AD, CA 92008 3-0153 CASH AND CHECK CUSTOMER , CA 92008 TARE NET -GATE Yr. 2 37,360 27,860 9,500 Qty: 0.00 Qty 4 .15 Unit Description TN MSW Scale In Tare Out 54 Ticket #:2803429 Weighrnaste.r: aceveos In: February 04 , 2025 Out: February 04 , 2025 Vehicle: a666 Ref: BOL: INBOUND CASH Rate Extension $101.2) $480.75 Tax S0.00 Origin: CARLSBAD 100% Total Paid Change Signature: EDIT CARD-SCALE 3:14 pm 3:14 pm Total $480,75 $480.15 $480.75 $0.00 V iv,.NSaER }).MINO REAL , CA 92008 03-0153 AND CHECK CUSTOMER NET Qty: -GATE Yr. 2 45,360 28,100 16,660 Q.00 Scale In Tare out 54 Ticket jl: 27:j&l07 Weighmaster: martios3 ln: January 22, 2025 Out: Vehicle: January 22, 202S a666 Ref: BOL: INBOUND CASH Rate Extension S101.21 $843.08 Tax $0.00 10:13 am 10:13 am Total $843.08 Qty 8.33 Origin: Unit Description TN MSW CAR:LSBAD 100% Total Paid Change .EDIT CARD-SCALE $843.08 $843.08 $0.00 V EDCO Station 8184 Commercial St. La Mesa, CA 91942 (619) 466-3355 customer: 0000 l PElIBZ BROTHERS 8184 COMMERCIAL ST LA MESA, CA 91942 Ticket: 86244 Date: 01/17/25 Commodity Units Rate In: Out: 55 C&D Certified 5.87 128.00 per TON 8:08 8:08 Truck: Container: Route: Origin: INVOICE 9001/9001 z 02055 020 SAN DIEGO fGross(In): 16.70 tons Scl#2 Tare 10.83 tons Stored Net: Extended Charge 751.36 5. 87 tons] PAID CREDIT CARD 751.36 Construction & Demolition Diversion Certificate --Diversion Percentage 65% Jhjs certifies that the company listed above has utilized an EDCO facility to divert construction demolition materials in accordance wtth LEED requirement. The diversion tonnage is based on an overall tonnage percentage of the respective EDCO facility. Miguel E. Driver