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Home My WebLink About1753 ANDREA AVE; ; CBR2023-5133; Recycle(cityof Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN 8-59 Deve/012.me11t Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov APPLICABLE TO NEW CONS RUCTION, RESIDENTIAL ADDITIONS AND ALTERATIONS OVER $6OK VALUATION AND COMMERCIAL ADDITIONS AND ALTERA T IONS OVER $200K . You are required to list materials that will be reused, recycled or disposed from your project. 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) 339-2719 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 Applicant Information Permit No. cJ3fZ.,'UJ1?J-6 \ ?~ Project Title Trujillo JADU Project Address 175j Andrea Ave Applicant Name Alena Brooks Blasio Last First Contractor [Z] APN Applicant Address 5145 Avenida Encinas, suite i, Carlsbad, CA 92008 Phone 760 729-3965 E-mail Address admin@thisisbawinc.com Applicant Mailing Address (if different than project address) Project Type (check all that apply): Residential [Z] Brief Description Convert garage to JADU Commercial □ Public Building □ Project Size 420 Estimated Cost of Project $_3_9_K ______________ _ (square footage) Please check the appropriate box: l ✓I I plan on using REPUBLIC SERVICES roll-off bin(s) for all materials and will provide all receipts after construction. D I plan on using a City Approved hauler and will provide all receipts at the final occupancy inspection. D This is a proposed LEED certified project. 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. P • t N Alena Brooks Blasio J~~ Date rm ame _____________ .Signature ___ ~--"C~-.2'-= ~~--~--11(25/23 Page 1 of 4 Rev. 2.10.21 Cicyof 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 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 documentation that 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 -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. APPLICANT CERTIFICATIONS: CHECK EA/OX 0 I certify under penalty of perjury under the laws of the State of California that the information j 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. I understand the waste diversion requirements of the State of California and submit this Construction Waste Management Plan pursuant to California Green Bu ilding 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 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. 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 construction or demolition activities. a.t.i:Z?~ Date 1/(~ Page 1 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 . C Bg20'2.~-5l~~ Project Title l(u.J ,· i l6 Project Address l 7 S3 Adre.~ Av~ APN Applicant Name Phone Last First m■ren,■:-Complete the following table with estimated waste tonnage to be generated by your project. A B C Material Type Estimated 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 fine of the table only if only using WASTE MANAGEMENT □ □ □ roll-oft bins. Mixed C&D Debris Asphalt & Concrete ,~ □ □ Gr' Brick / Masonry/ Tile □ □ □ Mixed Inert Debris 2.. □ □ GY' Cabinets, Doors, Fixtures, □ □ □ Windows (circle all that apply) Carpet □ □ □ Carpet Padding/ Foam □ □ □ Cardboard □ □ □ Ceiling Tile (acoustic) ~ □ □ □ Drywall (used, new, scrap) .< □ □ w Landscape Debris (brush, trees, □ □ □ stumps, etc.) No dirt. Unpainted Wood & Pallets □ □ □ Roofing Materials □ □ □ Scrap Metal □ □ □ Stucco .~ □ □ (3""' Other: □ □ □ TOTAL 0 -3 .5 Zv2-7s To meet 65% Diversion Requirement (estimate) X 0.65 = tons ~ :ol E>tlmoted Wost, from obo,, Minimum Required Diversion ApplicQ Signature 1/'i/L~ Date Page 2 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. C.BK 2D 23-S/5 ~ Project Title _:f(~rv-.~j-~~l \_o~------- Project Address l 7 5' AA<\<'~ Ave 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) Diversion Rate Achieved Actual Amt Reused or Salvaged 0 Total of columns A + B Attach the following documentation to this Report: • Original recycling weight tickets, landfill weight tickets Actual Amt Recycled 5 tons 0 Actual Amt Disposed in Landfill 0 = Total of columns A + B + C Destination Facility (Name, Address, Phone) Palomar Transfer Station, 5960 El Camino Real -(760) 603-0153 \ ' ..__ % G DIVERSION Return completed form and documentation to: 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 Recycling Report SECTION 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. ~ Applicant Signature .J~..,,,,L.:...._-==---b..-,,::.:::....:=--:::==:===-------Date Cf 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 5-cy X 0.18 = Demolition 1-cy X 1.19 = Asphalt/Concrete Asphalt (broken) cy X 0.70 = Concrete (broken) 2... cy X 1.20 = Concrete (solid slab) cy X 1.30 = Brick/Masonry/Tile Brick (broken) cy X 0.70 = Brick (whole, palletized) cy )( 1.51 = Masonry brick (broken) cy )( 0.60 = Tile sq ft Building Materials (cabinets, doors, windows, etc.) )( cy 0.00175 = Cardboard (flat) cy )( 0.15 = Carpet By square foot sq ft X 0.05 = By cubic yard cy )( 0.0005 = Carpet Padding/Foam sq ft )( 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 )( 0.0008 = Landscape Debris (brush, trees, etc.) cy )( 0.00105 = Asphalt Composition )( 0.25 Shingles, asphalt Shingle = cy Unpainted Wood/Pallets By board foot X 0.15 = bd ft 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 )( estimate = Total ALL = 0 Page 4 of 4 rev 4/24 ~~ REPUBLIC. ~..., SERVICES 5960 El Camino Real Carlsbad CA 92008 Customer Service (760)332-6464 RepublicServices.com/Support Important Information Account Number Invoice Number Invoice Date Past Due on 08/25/24 Payments/ Adjustments Current Invoice Charges 3-0661-1007275 0661-000628616 August 25, 2024 $508.48 $0.00 $128.43 Please remit your payment to Republic Services #661 , PO Box 78829 Phoenix AZ 85062-8829 or utilize www.republicservices.com/pay-bill; please do not use the Carlsbad return address on this invoice for payments Total Amount Due I Payment Due Date $636. 91 Past Due ,.,_R~ REPUBLIC' 1s-:v SERVICES 5960 El Camino Real Carlsbad CA 92008 CURRENT INVOICE CHAB:GES Description ~f"'V..d \ \ \ C) Reference Quantity Ba Worthing 1751 Andrea Ave CSA S014564534 Carlsbad, CA Contract: 9661001 (C10) 1 Waste Container 3 Cu Yd, On Call Service Pickup Service 08/19 Trujillo 1.0000 Receipt Number 9174 CURRENT INVOICE CHARGES, Due by September 24, 2024 Simple accoun t access at your fingertips. Download the r~epublic Services app or visit RepublicServices.com today. Past Due Please Return This Portion With Payment Total Enclosed 60 Days $0.00 Total Amount Due Payment Due Date Account Number Invoice Number Return Service Requested I 111111 1111 ,I 11 111111111ii1111 • I• 1 I I I I I I 1111111111111 111111ll 1111 Make Checks Payable To: Unit Price $128.43 ·D 90+ Days $0.00 Amoun1 $128.4~ $128.4:! ~\2,~.4~ -$898.91~ Past Due 3-0661-1007275 0661-000628616 ,,. BA WORTH I NG :;; ~ 5145 AVENIDA ENCINAS :i o.. CARLSBAD CA 92008-4322 :f ,111 111 .i 1 ,11, 111, 11111 .. 111 11111, 1,, 1, 111111111.1 ,, , 111111111111 REPUBLIC SERVICES #661 PO BOX60586 CITY OF INDUSTRY CA 91716-0586 3066110072750000 □006286160000128430000636911 I R, ~ .1 REPUBLIC' ~... SERVICES 5960 El Camino Real Carlsbad CA 92008 Account Number lnvolce Number 3-0661-1007275 0661-000622243 July 25, 2024 Customer Service (760)332-6464 RepublicServices. com/Support Important Information Invoice Date Previous Balance Payments/Adjustments Current Invoice Charges $71 .12 -$71 .12 $508.48 Please remit your payment to Republic Services #661 , PO Box 78829 Phoenix AZ 85062-8829 or utilize www.republicservices.com/pay-bill; please do not use the Carlsbad return address on this invoice for payments Total Amount Due I Payment Due Date $508.48 August 24, 2024 5960 El Camino Real Carlsbad CA 92008 PAYMENTS/ADJUSTMENTS Description Beterence Payment -Thank You 07/26 93227 CURRENT INVOICE CHARGES Descri12tion Reference Quantity Ba Worthing 1751 Andrea Ave CSA S014564534 Carlsbad, CA Contract: 9661001 (C10) 1 Waste Container 3 Cu Yd, On Call Service Pickup Service 06/26 Trujillo 1.0000 Receipt Number 92430 Pickup Service 07/01 Trujillo 1.0000 Receipt Number 93604 Pickup Service 07 /11 Trujillo 1.0000 Receipt Number 97080 Pickup Service 07/25 Trujillo 1.0000 Receipt Number 1641 CURRENT INVOICE CHARGES Sir11ple account access at your fingertips. Download tilt~ l~epublic Se rvices app or visit RcpublicServices.com today. Please Return This Portion Wilh Paymenl Total Enclosed Total Amount Due Payment Due Date Account Number Invoice Number Return Service Requested 11I1 11111h111• • 11111" •h 11111111 I h 111 ll111 •111 111• 1• I pl Ii p 11 Make Checks Payable To: Amount -$71 .12 Unit Price Amount $123.19 $123.19 $128.43 $128.43 $128.43 $128.43 $128.43 $128.43 $508,48 $508.48 August 24, 2024 3-0661-1007275 0661 -000622243 ,. BA WORTHING ~ ! 5145 AVENIDA ENCINAS ., .,, .. CARLSBAD CA 92008-4322 :~ 111 I' 11' I, I h I •I 1111 1111 I• 111ii1 1111111 I I I I I' 1• 11111 I 1' I 1•11 I 11 I• REPUBLIC SERVICES #661 PO BOX 78829 PHOENIX AZ 85062-8829 30661100727500000006222430000508480000508486 '<R~ REPUBLIC. .... SERVICES 5960 El Camino Real Carlsbad CA 92008 Customer Service (760)332-6464 RepublicServices.com/Support Important Information Account Number Invoice Number Invoice Date Previous Balance Payments/Adjustments Current Invoice Charges 3-0661 -100727S 0661-000588136 June 25, 2024 $0.00 -$175.26 $246.38 Your next invoice may reflect a rate adjustment. Please contact us with any questions. Total Amount Due I Payment Due Date $71.12 July 25, 2024 ~Rwp REPUBLIC" ~\l SERVICES 5960 El Camino Real Carlsbad CA 92008 PAYMENTS/ADJUSTMENTS QescriQtion Reference Payment -Thank You 06/10 93087 CURRENT INVOICE CHARGES DescriQtion Reference Quantit~ Ba Worthing 1751 Andrea Ave CSA S014564534 Carlsbad, CA Contract: 9661001 (C10) 1 Waste Container 3 Cu Yd, On Call Service Pickup Service 06/03 Trujillo 1.0000 Receipt Number 85366 Pickup Service 06/11 Trujillo 1.0000 Receipt Number 88200 CURRENT INVOICE CHARGES Sirnple acco unt access at your fin gert ip s. Download the Republic Se rvices app or visit Republ icServi ces.corn coday. Please Return This ?ortion With Payment Total Enclosed Total Amount Due Payment Due Date Account Number Invoice Number I I .. I Return Service Requested I 11111111111111111•1 ht 11111111h11111111111111111 111111, 111111 II Make Checks Payable To: Amount -$175.26 Unit Price Amount $123.19 $123.19 $123.19 $123.19 $246.38 $71.12 July 25, 2024 3-0661-1007275 0661-000588136 .. BA WORTHING ~ ~ 5145 AVENIDA ENCINAS ~ ~ CARLSBAD CA 92008-4322 O Ill ::: .E 111• •1 11• 11111 11111• 11 11• 111•• • 11111111111 •1·111111 •11111111 •111 1 REPUBLIC SERVICES #661 PO BOX 78829 PHOENfX AZ 85062-8829 306611007275 □0000005881360000246380000 □71126 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 5,920 Scale In TARE 4 ,700 Tare Out NET 1 ,220 Tracking Qty: 0 .00 Unit Description TN MSW 54 Ticket #: 2693184 Weighmaster: marticy In: May 08 , 2024 Out : May 08 , 2024 Vehicle : a105310 Ref: BOL: INBOUND INVOICE Rate Extension $96.28 $58.73 Tax $0 .00 Qty 0.61 Origin: CARLSBAD 100% C Signature : Total Paid Change 2 :55 pm 2:55 pm Total $58.73 $58.73 $0.00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING, I NC 5145 AVENIDA ENCINAS STE#I CARLSBAD, CA 92008 Contract: COMM-GATE Yr . 200 GROSS 7,020 TARE 4,700 NET 2,320 Tracking Qty: 0.00 Qty 1. 16 Unit Description TN MSW Origin: CARLSBAD Signature : Scale In Tare Out 100% l'i'~ Ticket #: 2692848 Weighmaster: aceveos In : May 08, 2024 Out : May 08, 2024 Vehicle: al05310 Ref: BOL: INBOUND INVOICE Rate Extension $96.28 $111.68 Tax $0.00 Total Paid Change 7:53 am 7:53 am Total $111.68 $111.68 $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 6 ,100 TARE NET Tracking Qty: 4 ,700 1 ,400 0.00 Qty Unit Descri ption 0. 70 TN MSW Origin : CARLSBAD Signature: 54 Ticket #: 2 692566 Weighmaster : marticy Scale In Tare Out 10 0% In: May 07 , 2024 Out: May 07 , 2024 Vehicle: a105310 Ref : BOL: INBOUND INVOICE Rate Extension $96 .28 $67 .40 Tax $0 .00 To tal Paid Change 12 :09 pm 12:09 pm Total $67. 40 $67.40 $0 .00 $0 .00 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD, CA 92008 (760)603-0153 018616 -B.A WORTHING , INC 5145 AVENI DA ENCINAS STE#I CARLSBAD , CA 92008 Contract : COMM-GATE Yr. 200 GROSS 6,100 Scale I n TAR E 4, 700 Tare Out NET 1 ,400 Tracking Qty: 0.00 Qty 0 .70 Unit Descri ption TN MSW ~,4 Ticket #: 2686391 Weighmaster : marticy In : April 2 2 , 2 0 2 4 Out : April 22 , 2024 Vehicle: al05310 Ref : BOL : INBOUND INVOICE Rate Extension $96.28 $67.40 Tax $0.00 Origin : CARLSBAD 100% $33.70 each Signature: (/- ,. . ., 'L' _,/1 /1 I I --~ ,-_-·---:-+--=--1,J--f----"J\'----'-'r. ~j_ ___ ,· _l f _, __ 1 {,· / C' l'tt~ r u J c ·v L.{,t,1 r-_ ,, . • t C V Total Paid Change 2:42 pm 2:42 pm Total $67.40 $67.40 $0.00 $0.00