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Home My WebLink About1061 BUENA VISTA WAY; ; CBR2024-3005; 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 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 Serv ices 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 roH-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 _?RTIFICATION: ref I certify under penalty of perjury under the laws of the State of California that the information rovided in and with this form pertains to construction and demolition debris generated only from the roject listed in PART 1, that I have reviewed t he accuracy of the information, and that the nformation is true and correct to the best of my knowledge and belief. 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 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 lition activities. Date:_f _• _t_. ,w-i, __ S--__ 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. SECTION A Permit No. _____ -,--______ Project Title _._._.. ____ _,·'-'---'i'&'/\-=---'------------- Project Address I 0(0,l (;&fuv,..-\J t,<,-\;...,W'ff, ~(l)\-JJ Cfr jt,oof APN l SS • i.s\ • l~ -00 Applicant Name ~ ~ Phone 9\.(j . tt<:f' Cec ti-.. Last First 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) Page 2 of 4 A B C Plac,e 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 _'2_•_v_1-___ x o.6s = __ 1.._._'--(.;.._7,_l_S--____ tons Total Estimated Waste from above Minimum Required Diversion 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 Perm it No. ------.---:,----,-------;--,---.,Pr~ect Title P<ojectAdd,ess !Ola\ 0Jtu-~~ CHlsiJ \'.A--"'\'Lto'i Applicant Name Jb~~ J Pf \~ Phone Last First l SS°'-i..s-l-ttt-uo 2J:<l ., Ceor)..... SECTION B 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 Material Type Actual Amt Reused or Salvaged Exam12_te: 01/01/2020 Concrete (broken) ,. c-rJe... bro~ ? dL \..bll) 1/11(wi-r 0,YI . f 111 D,rf z, (I 1AJ1,.( WM"fL S"' I I 'L,Q'l,f wt---5c(......- I '2. t ~ 1.-bv-{ w "-<; \ <-- erotM 0 Diversion Rate Achieved tc;.,3 _______ __,! Total of columns A + B Attach the following documentation to this Report: • Original recycling weight tickets, landfill weight tickets Actual Amt Actual Amt Destination Facility (Name, Address, Phone) Recycled 5 tons 'Z -1 1.. (£ 1 ... "f '2 . 1 ·2..•f (.f> I c ).r, t"l . 1.:1_ Disposed in Landfill 1-tt.f I 1-o't Palomar Transfer Station, 5960 El Camino Real -(760) 603-0153 _ ___ = __ .,._, __ % ~ 65% Toto/ of columns A + B + C DIVERSION Return completed form and documentation to: City of Carlsbad • Original donation receipts with photos and/or itemized descriptions Building Division (1st Floor) 1635 Fara day 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 t o construction and demolition debris generated only from the project listed in PART 1, that I have reviewed the accuracy of the information, and that t he information is true and correct to the be st of my knowledge and belief. Applicant Signature _.,,.__,__ ___ ~-------------Date _5_/_t _'f_/_UJ_'2,._b ______ _ Page 3 of 4 rev 4/24 ., PALOMAR TRANSFER • 5960 EL CAMINO REAL CARLSBAD ,· CA 92008 (760)603-0153 000999 -CASH AND CHECK CUSTOMER ADDRESS carlsbad , CA 92008 Contract : RESI -GATE Yr . 2 GROSS 16,000 Scale In TARE 10,400 Tare Out NET 5 ,600 Tracking Qty : 0.00 Qty 2 .80 Unit Description TN MSW 54 Ticket #: 2815043 Weighmaster : aceveos In : March 06 , 2025 Out : March 06 , 2025 Vehicle : a108673 Ref : BOL : INBOUND CASH Rate Extension $101.2] $283 .39 Tax $0 .00 Origin : CARLSBAD 100% Signature : Total Paid Change .EDIT CARD-SCALE 12 :43 pm 12 :43 pm Total $283 .39 $283.39 $283 .39 $0 .00 V PALOMAR TRANSFER 5960 EL CAMINO REAL °CAR~SBAD ,_CA 92008 (760) 603-0153 000999 ~ CASH AND CHECK CUSTOMER ADDRESS carlsbad, CA 92008 Contract : RESI -GATE Yr . 2 GROSS 12 ,660 TARE 10,400 NET Tracking Qty : 2 ,260 0 .00 Qty 1.13 Unit Description TN MSW Scale In Tare Out 54 Ticket #: 2837744 Weighmaster : GordiWe In : May O 1 , 2 0 2 5 Out : Vehicle : Ref : BOL : INBOUND CASH May 01 , 2025 al08673 Rate Extension $101 .2] $114 .37 Tax $0 .00 Origin : CARLSBAD 100% Signature : Total Paid Change .EDIT CARD-SCALE 2 : 13 pm 2:13 pm Total $114 .37 $114 .37 $114.37 $0.00 V CONSTRUCTION & DEMOLITION DIVERSION CERTIFICATE RECEIVED AT: MOODY'S -EL CORAZON RECLAMATION PROCESSED AT: 3210 OCEANSIDE BLVD., OCEANSIDE, CA (760) 433-3316 P.O. JOB# CASH CHECK CHARGE COMMERCIAL TIME .. NAME CITY OF ORfGIN JOB LOCATION I TONS I DIVERSION 100% PU I TRAILER ,. I FLATBED BOBTAIL 110-WHEEL I END DUMP I T & T ~ MATERiAl , LOAD COUNT 1 2 3 4 5 6 7 8 9 10 ,, ' -- # LOADS X PRICE OTHER CHARGES SIGNATURE This certifies that the company above has utilized a recycling facility to divert construction demolition materials in accordance with LEED requirements. The diversion is based on an overall tonnage percentage of the respective facility. $ TOTAL DUE TRUCK# MOODY'S is not responsible for damage to vehicle while being loaded or unloaded in yard. JOB COPY 3 663 CONSTRUCTION & DEMOLITION DIVERSION CERTIFICATE RECEIVED AT: MOODY'S -EL CORAZON RECLAMATION PROCESSED AT: 3210 OCEANSIDE BLVD., OCEANSIDE, CA P.O. CASH CHECK NAME CITY OF ORIGIN JOB LOCATION (760) 433-3316 JOB# CHARGE COMMERCIAL \, \ I \ DATE RESIDENCE \ TIME DIVERSION ITO~S -\ 100% PU I TRAILER_ I FLATBED BOBTAIL 110-WHEEL I END DUMP I T & T MATERIAL '• LOAD COUNT ' ' 1 2 3 4 5 6 7 8 9 10 .. - I I # LOADS X PRICE OTHER CHARGES SIGNATURE This certifies that the company above has utilized a recycling facility to divert construction demolition materials In accordance with LEED requirements. The diversion is based on an overall tonnage percentage of the respective facility. $ TOTAL DUE .... ' TRUCK) MOODY'S is not responsible for damage to vehicle while being loaded or unloaded in yard. JOB COPY 3 097 ..y ... CONSTRUCTION & DEMOLITION DIVERSION CERTIFICATE RECEIVED AT: MOODY'S -EL CORAZON RECLAMATION PROCESSED AT: 3210 OC EANSIDE BLVD .,,,CEAN SIDE, CA (760) 433-3316 1 ~-~I -~ P.O. CASH CHECK NAME CITY OF ORIGIN i . - JOB LOCATION J . - JOB# CHARGE i , I .,. -.. . -· DATE ,.,.- / RESIDENCE ITO~S f I DIVERSION 100% - PU . I TRAILER I FLATBED BOBTAIL j 10-WHEEL I END DUMP I T & T \ ~ -MATEf!IAL ; , LOAD COUNT . ; ' 1 2 3 4 5 6 7 8 9 10 -1· , / --I # LOADS X PRICE OTHER CHARGES , SIGNATURE This certifies that the company above has utilized a recycling facility to divert construction demolition materials in accordance with LEED requirements. The diversion is based on an overall tonnage percentage of the respective facility. $ / I (_ TOTAL DU E . I l { t TRUCK# MOODY'S Is not responsible for damage to vehicle while being loaded or unloaded in yard. JOB COPY 353039 {7ul.N--v ~~ vf'J( 9\'(\ ~ County of Orange OC Waste & Recycling ~ l?rima Desheoha Landfil Credit Card Receipt FSA: VXR DATE :12/12/24 'IIME; 07: 07 JIJ1 TICKET Ii : 603~663 _ L?Jr~Jl.JR') CUSTCMER: 999901 ,~ LP CASH ONLY SM.ART CARD NUMBEf-1 : DECAL ID: 12277N2 LICENSE: 12277N2 VEHICLE: 10 ~. 00·-4 . 49 TON TRUCK TAAILER: A41338 TRANSACT TON : 21) -L'a:; h/Chec.:k/Ct·edi t ORIGIN: 1830 -sec SAN CLEMENTE COM DESTINATION: Nc,t Spac-i fi ed +IATERIAL: 1 -r.11 GENERAL WASTE 0-iARGE TYPE: 30 NonCnt Standard Rate PAYMENT : s -cr .. dit C'at·d GROSS TARE 8 .13 5 .29 NET RATE : TOTA!, FEE : DEPOSIT: CC DEJ?OSI'l': TENDERED : CHANGE : 2.84 66.65/TN 189.00 0 .00 0 .00 189 .00 0.00 Refe~ence #: 26537922 Card #: XXXXXXXXXXX3005 Auth #: 82594~i 603283663 Layout F8 County of Orange OC Waste & Recycling Prima Desheoha Landfil Credit Card Receipt FSA : EIE DATE: 09/~1/24 TIME:01 :13 PM 603213103 I cusrc.«,, 999901 l o[s'[,i,.( LP CASH ONLY (Q]W@ SMART CARD NUMBER/•• DECAL ID : 12:77N2 LlCENSE: 1227'iN2 VEHICLK : 10 4.00-~.49 T0N TRUCK TRAILER: MB3~ TRANSACTION : 20 -Casl,/Check/Ccedit O!Ut:,IN: ]830 -:;cc SAN CLEMENTE COM DES1'INATION: Not Specified MATERIAL: 1 -&l GtNERAL WASTE CHARGE TYPE : 30 HonCnt ~t,mdatci Rate PAYMENT : S -Crndi. t Ca rd GROSS TARE HE'l' 6.54 5 .29 1.25 RATE: 66.65/TN TOTAL !!'EE: DEPOSIT : CC DEPOSIT: TENDERED : CHANGE: Rttference ti Card #: XX}' J.l.uth #: 846 83.00 0 .00 0.00 83.00 0.00 ,-·'.J 603213103 Layout FS BALANCE FORWARD I 4 -l{-ZOLf 00161 DATE fl) TO C}_uvA I\( ~I { FOR tAJ /..-~TL SUB-TOTAL G \J tA-n ,..__, lfr>1-THIS Jo e>::> CHECK OTHER TRANSACTION +OR· 0 TAX DEDUCTIBLE BANK BALANCE Ordtr I 3718370-1 .";ONSTRUCTION & DEMOLITION DIVERSION CERTIFICATE RECEIVED AT: MOODY'S -EL CORAZON RECLAMATION PROCESSED AT: 3210 OCEANSIDE BLVD., OCEANSIDE, CA (760) 433-3316 P.O. JOB# DATE CASH CHECK CHARGE COMMERCIA , RESIDENCE J ,, .,.,. NAME CITY OF ORIGIN i -• ._I • l I JOB LOCATION ITONS I DIVERSION ' 100% -, PU I TRAILER I FLATBED BOBTAIL -110-WHEEL I END DUMP I T & T '--- MATERIAL -/ • I LOAD COUNT --' ( ' 1 2 3 4 'o 6 7 8 9 10 - ' ' J I #LOADS X PRICE SIGNATURE This certifies that the company above has utilized a recycling facility to divert construction demolition materials in accordance with LEED requirements. The diversion is based on an overall tonnage percentage of the respective facility. ,, OTHER. CHARGES $ I TOTAL DUE I I . I TRUCK # MOODY'S is not responsible for damage to vehicle while being loaded or unloaded in yard. JOB COPY 35 695 ) .,