HomeMy WebLinkAbout2548 CAMPBELL PL; ; CBC2023-0375; Recycle(city of
Carlsbad
CONSTRUCTION WASTE
MANAGEMENT PLAN
B-59
Development Services
Building Division
1635 Faraday Avenue
442-339-2719
www.carlsbadca.gov
APPLICABLE TO NEW CONSTRUCTION, ALL RESIDENTIAL ADDITIONS AND ALTERATIONS AND
COMMERCIAL 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 L3 Harris Renovation of Bldg. N4
Project Address 2548 Campbell Place, Carlsbad, CA 92009
Applicant Name Pacific Building Group Contractor
0 Last First
Applicant Address 9752 Aspen Creek Court, San Diego, CA 92126
Phone ( 858 ) 552-0600 E-mail Address
Applicant Mailing Address
(if different than project address)
Project Type
(check all that apply):
Residential Commercial
□ 0
Public Building □
Brief Description Tenant Improvement including Demo, Mechanical, electrical
APN
Architect Other □ □
Project Size 10,578 Estimated Cost of Project $_$_2_·_2_M _____________ _
(square footage)
Please check the appropriate box:
I plan on using REPUBLIC SERVICES roll-off bin(s) for al l 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 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.
1 ~!u1n•d by Jacqueline hnuite
P . t N Jacqueline Tahuite . Jacqueline TahuIt0 Jl""ull,Opacilkbulldiao,,wpoom, rm ame _____________ S1gnature c.~,.,,r,,,.,,. . . Date 2/14/2024
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:
• ' Permit No. Project Title L3 Harris Renovation of Bldg. N4
Project Address 2548 Campbell Place, Carlsbad , CA 92009 APN
Applicant Name Pacific Building Group Phone ( 858 )552-0600
Last First
-,~-••tm■: 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.
Goal: the diversion rate shall be 65% by weights of debris.
A B C
Material Type Estimated Pl ace a (i.i) check Place a (i.i) check next Place a (i.i) 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 fine 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 2.2T □ X □ □
Carpet Padding/ Foam □ n n
Cardboard □ n □
Ceiling Tile (acoustic) 3.45T □ □ X □
Drywall (used, new, scrap) 1.12T □ X n □
Landscape Debris (brush, trees, □ stumps, etc.) No dirt. □ □
Unpainted Wood & Pallets □ □ □
Roofing Materials □ □ □
Scrap Metal .73T □ X □ □
Stucco □ n n
Other: Ductwork 1.9T □ □ X □
TOTAL = 9.40T
•
To meet 65% Diversion Requirement (estimat e) 9.40 X 0.65 = 6• 11 tons
Total Estimated Waste from above Minimum Required Diversion
OlilellyPi!l!KbyJ~T~,
Contractor/Owner Signature J acqueline T ahuite ~~!=""'~""-· Date 2/14/24
Page 2 of 4 Rev. 05/22
PART 2 Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final
building approval.
DEBRIS RECYCLING REPORT (ACTUAL):
-..,iiiiil•■r111.,••-..1 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. C.BG.Z.O:J.~-0~'15 Print Name L'?, M AAl'IS T :t
Address 2.SLfS CAl'\P ~ I.LL-p ... C.AA'-'':l "'o CA q 'J.Od'f Date ~II-'{ I l,OZ, 'f -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
Material Type Actual Amt Actual Amt Actual Amt Destination Facility Date Reused or Recycled Disposed in (Name, Address, Phone)
Salvaged Landfill
ExameJe: Palomar Transfer Station, 5960 El
01/05/2018 Concrete (broken) 5 tons CominoReol
-(760) 603-0153
3/5/24 Trash 3.30T EDCO Station, La Mesa, CA -3/6/24 Metal 2.60T Allan Company, San Diego, CA --·-
3/8/24 Metal 2.09T Allan Com any, San Diego, CA
3/11/24 Trash 3.81T EDCO Station, La Mesa, CA --3/18/24 Carpet 2.21T LA Fiber Co, Los Angeles, CA -
-
----
I--
□TOTAL 6 .. 90T 7.11T
-..,.,,,.
~ 65%
Diversion Rate Achieved 6.9 I 14.01 = 50 % $65%0
Toto/ of columns A+ B Toto/ of columns A+ B + C DIVERSION
Contractor/Owner Signature J11uJ-/ j,4-t.~ LP" 6-s I'" I 1-0 z.-1 -Date
Attach the following documentation to this Report: 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) . Any other relevant Information to support Recycling Report 1635 Faraday Avenue
Carlsbad, CA 92008
Rev. 51612022
3825 Bancroft Drive, Spring Valley, CA 91977
P-619-589-6001 F -619-589-7158
CONSTRUCTION AND DEMOLITION DEBRIS RECYCLING LOG
Daily Log of Construction and Demolition (C&D) Materials Removed or Reused on Job Site
Date: 4/25/2024
Project: L3 Harris Reno of Bldg N4
Address: 2548 Campbell Place, Carlsbad, CA 92009
DATE TICKET NO.
3/5/24 66505
3/6/24 TSDYOS
3/8/24 TSDYQJ
3/11/24 68896
3/18/24 240329H
TOTAL RECYCLED:
49%
DESTINATION
EDCO Station
Allan Comoanv
Allan Comoanv
EDCO Station
LA Fiber Comoanv
LOCATION
La Mesa CA
San Dieao CA
San Dieao CA
La Mesa CA
Los Anaeles CA
Job No: 1-23-1806
Customer: Pacific Building Group
(TONS) (TONS)
RECYCLED TRASH % RECYCLABLE
3.30 0%
2.60 100%
2.09 100%
3.81 0%
2.21 100%
6.90 7.11
Name of Person Verifying Accuracy:
s1goa1,ra , 7 L_ ana Ap claoef
// ,
MATERIAL TYPE
Refuse
Metal
Metal
Refuse
Caroel
Certification for Recycled Used Carpet
• Certification: 240329H
• Date: March 18, 2024
• Location: Pacific Building Group
2548 Campbell Place
San Diego, CA
• Square Yards: 490 (4,410 square feet)
The carpet removed from your premises was
sent to our recycling facility, processed and
recycled into new products and new uses.
None of the carpet was sent to a landfill.
Thank you for making a difference in our
environment, our community, and our future.
rmco Station
8181 Commercial St .
L,a Mesa, CA 91942
(619) 466 -3355
Customer: 0171
CASPER CO
Ticket :
Date :
3825 BANCROFT DR.
SPRING VALLEY CA 91977
Commodity
30 Roll Off Refuse
[Gross (In) : 20 . 59
\_}C> b.#' .,.:lye> tJ s-J
ur;i.its
3.81
tons Scl#l
oJ. s-y-8 ~p&I I Pt.
CHRIS
68896
03/11/24
o\o# ZJ.f oo r;~
PD:tl-1 lo2Z4
t)5
In: 12 :43
Out : 12:43
Rate
Truck:
Container:
Route:
Origin:
INVOICE
1108/1108
J
02030
020 SAN DIEGO
Tare 16.78 tons Stored Net: 3 .81
Extended
Charge
438.15
tons]
TOTAL DUE 438.15
Driver
WEIGIIMASTER CERTIFICATE
TRUCK SCALE
** REPRINTED ON 03/08/24 **
Ticket#: TSDYQJ
Purchased From: CASP02 SIIIP DATE: 03/08/24
CASPER COMPANY
3825 BANCROFT OR
SPR ING VALLEY, CA 91977
Veh II 28668M1 ID II CASPER
ALLAN COMPANY
5165 CONVOY STREET
SAN DIEGO, CA 92111
PHONE: (858) 268-8971
FAX: (858) 268-8972
SHPMNTtl COMMOO !oT1Y
TSDYQJ MIXED LOAD
GROSS TARE N8T1
37540a 33360a 4180
1AOJ REASON
0
RED 0/~I RO EX•T PO WT!
4180
PRICE UM TOT-AL AMT
0.0 0.00 0.0000 * 0.00
ALL WEIGHTS ARE REPORTED IN POUNDS UNLESS OTIIERWISE INDICATED. ALL NON -POUND WEIGHTS ARE ASSUMED TO BE MANUAL ~IEIGIITS
TOT'AL·S 0 0.0
Ticket Comment: 2548 CAMPBELL PL/ LIGHT STEEL/ KIAN
WEIGHMASTER SIGNATURE
CUSTOMER SIGNATURE
(MAGDALENA ORTIZ)
GRS Date 03/08/24
GRS Time 08:50
TRE Date 03/08/24
TRE Time 08:57
jSHORT TO\IS
I 2.0900
I
I
o=SCALE 1 b=SCALE 2 c=SCALE 3 d=SCALE 4 m=MANUAL WE I GHT
WEIGHMASTER CERTIFICATE
THIS IS TO CERTIFY lhat lhe following described commodity was weighed, measured, or counled by a weighmaster, whose slgnalure Is on lhls
cer1Ificate, who Is a recognized aulhorily or accuracy, as prescribed by Chapter 7 (commencing wllh Section 12700) of Division 5 or the California
Business and Professions Code, administered by the Division or Measurement Standards of the California Department ol Food and Agriculture.
0.00
'2-:7~ ~ C f>,-M ~6lL fl
WEJGHMASTER CERTIFICATE
TRUCK SCALE
Purchased From: CASP02
CASPER COMPANY
3825 BANCROFT DR
SPRING VALLEY, CA 91977
Ticket#: TSDYOS
SHIP DATE: 03/06/24
Veh # 2866BM1 ID # CASPER
• • . yt-t-, ~!I\ iu,*,e~~lb,tf~ .sli~r:,_N'ftt;t~<?f1~Q_O;~ht{:;.
TSDYOS MIXED LOAD 38420a 33220a 5200
A
0
ALLAN COMPANY
5165 CONVOY STREET
SAN DIEGO, CA 92111
PHONE: (858) 268-8971
FAX: (858) 268-8972
0.0 0.00
~&-;•tf.\-bgJ:x...-:~~
. _ 1;-i.TPJIA!.Y~P,
0.0000 * 0.00
ALL WEIGHTS ARE REPORTED IN POUNDS UNLESS OTHERWISE INDICATED. ALL NON·POUND WEIGHTS ARE ASSUMED TO BE MANUAL WEIGHTS
lt~~;:; ~-~ >~
f~ff~T·O~.
Ticket Conment: 2548 CAMPBELL PL. / LIGHT STEEL/ KIAN
WEIGHMASTER SIGNATURE
CUSTOMER SIGNATURE
(MAGDALENA ORTIZ)
a=SCALE 1 b=SCALE 2 c=SCALE 3 d=SCALE 4 m=MANUAL WE!G~T
WEIGHMASTER CERTIFICATE
+-------------------+
GRS Date 03/06/24
GRS Ti me 14:58
TRE Date 03/06/24
TRE Time 15:04
!SHORT "TONS
I 2.6000
I
I
+---·---·--··------·+
THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose signature is on this
certificate, who Is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) or Division 5 of the Callromla
Business and Professions Code, administered by the DIVlsion of Measurement Standards of the California Department of Food and Agriculture.
EDCO Station
8184 Commercial St.
La Mesa, CA 91942
(619) 466 -3355
Customer: 0171
CASPER CO
3825 BANCROFT DR.
SPRING VALLEY CA 91977
Ticket: 66505
Date: 03/05/24
Commodity Units Rate
30 Roll Off Refuse 3.30
0 -5
In: 10:39
Out: 10: 39
Truck:
container:
Route:
Origin:
INVOICE
0002/0002
w
02030
020 SAN DIEGO
[Gross(In): 20.22 tons Scl#2 Tare 16.92 tons Stored Net:
Extended
Charge
379.50
3. 30 tons]
TOTAL DUE 379.50
Miguel E. Driver