HomeMy WebLinkAbout1310 KNOWLES AVE; ; CBR2023-1575; RecyclePART 2 Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final
building approval.
DEBRIS RECYCLING REPORT (ACTUAL):
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 generat d only from the project listed in PART 1, t hat 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. GSR 202 3 -15 ~s-Print Name CC, Ne \son -'2.c.-,{'(\c:.'Y-__ __,___c.. _____ ---1
Address _l 3~,o~\<~Y)~O~w~\cs~~"--',)~C,..~{Q.~v~ls~b'4~d~G~l\:~C\_2_00~_B_Date \ 2 -0 -2..3
Use this Final Log below to track loads of materials as they leave the job site.
□ □SAVE RECEIPTS □ 0
Indicate FI NAL quantities in tons for each material and save receipts and documents from facilities where material is taken.
Additional Project Log pages are avai lable if neces sa ry. Use City Conversion Table tp convert volume to tons.
Date
Example:
01/05/2018
Material Type
Concrete (broken)
A
Actual Amt
Reused or
Salvaged
B
Actual Amt
Recycled
5 tons
C
Actual Amt
Disposed in
Landfill
Destination Facility
(Name, Address, Phone)
Palomar Transfer Station, 5960 El
Camino Real
-(760) 603-0153
Diversion Rate Achieved --------~-----------= _____ %
~ 65%
s; 65%
Total of columns A + B Total of columns A + 8 + C DIVERSION
Contractor/Owner Si~-.-:::::~~<f:~~>~~===:.......:::...,=~Daatte ~/4 ~ 3/ -
Attach the following documentation to this Report: Return col1:ted form and documentation to:
• Original recycling weight tickets, landfill weight tickets
• Original donation receipts with photos and/or itemized descriptions
• Any other relevant information to support Recycling Report
City of Carlsbad
Building Division (1st Floor)
1635 Faraday Avenue
Carlsbad, CA 92008
Rev. 5/6/2.022
Escondido Resource Recovery
1021 W Mission Ave
Escondido, CA 92025
(760) 745-3203
Customer: 0000 Ticket: 93200
Date: 07/05/23
THOMSAS L
Commodity Units Rate
INVOICE
In: 10 :42 Truck: 0000
Out: 11:10 Container :
Route: 01611
Origin : 016 Escondido
11 SELFHAUL REFUSE 1.30
[Gross(In): 11,480. lbs Scl#5
115.00 per TON .
Tare 8,880. lbs Scl#5
Extended
Charge
149.50
Net: 2,600. lbs]
PAID CREDIT CARD
VINCE Driver
149.50
[~,;OtiJll)O ~~SOURCE ~
J04~ U ~,1SIIINGTON AVE
ESCOr.JlOO, C,1. 92025-1E72 71i€ -745-3203
IForce
1 mxxxxxxxxxs.916
DISCOVER
Total: $
07,~5123
Inv ": 000000041
AP~rvd: Onlir1:
Di~{over Credit
Al[1: ~0000001.52ll10
M:: 00 00 00 80 f@
rs1: EB 00
Entrv Mhod: Ch[P
·L4•=1 ~·ii:• .. ~ ...... , l!J
11: 10:•13
APPr (ode: 00o1:1R
Cu i l•Jm•:-1 CoPY
fl ,1NI\ YOU!
Escondido Resource Recovery
1021 W Mission Ave
Escondido . CA 92025
(760) 745-3203
Customer : 0000 Ticket: 89040
Date: 06/27/23
THOMAS L
Commodity Units Rate
INVOICE
In: 13:48 Truck: 0000
Out: 14:04 Container:
Route: 01611
Origin: 016 Escondido
11 SELFHAUL REFUSE 1.64
[G ross(In): 15.800 . lbs Scl#5
98.00 per TON
Tare 12.520. lbs Scl#5
Extended
Charge
160.72
Net: 3.280. lbs]
PAID CREDIT CARD
ALMA Driver
160.72
E~COIIJWU RE~(~ 104~ (I ~ASHltlGTON AVE
ESCIJl{)1DJ. C.~. 92025-1£72
7,;f • 7,15 -3203
IFoirce
mxxxxxxmS-916
DISCOVER
Total: $
06117123
Inv U : 000000076
AP~rvd: Onlirie
Discover (redlt
AID: A00000015Wll0
fVR: 00 00 00 8H0
rs!: EB 00
Entry Mhod: ChlP
:L612l. i':2
l'l:05:l6
APPr (ode: 0271.lR
rl ~I< YOU!
l:scondi do Resource Recovery
10?.1 W Mission Ave
l:scondi do. CA 92025
(160) 7~5-3203
Customer : 0000 Ticket: 78694 Date: 06/09/23
Tl IOMAS L
Commodity Units Rate
INVOICE
In: 13:41 Truck: 0000
Out: 14:00 Container:
Route: 01611
Origin: 016 Escondido
11 SELFHAUL REFUSE 1.13
1·cross(In): 11,280. lbs Sc l#5
98.00 per TON
Tare 9,02 0. lbs Scl#5
Extended Charge
110. 74
Net: 2, 260 . lbs J
PAID CREDIT CARD
VINCE Driver
110. 74
t~C(JII •1 llO RESOUl<Ct ~ t&H ll ~,:,S,1£NGTON AV[ [•,,.0~O[1.lJ. C,\. 92025-1E72
71i~ • 71~ .3203
force
,xxxxmxx$916
COVER
iota!: $
06109123
Inv ": 000000071
A~~rvd: On! ir,~
Di~-cover Credit
AID: A0000001523ll0
lVR: 00 00 0f1 80 £0
TS!: E8 00
Enlrv Mhod: 01lP
11,a. -,.q
H:00: l2
APPr [ode: 00911lR
l~~r-.< YOU!
• PALOMAR TRANSFER STA
5960 EL CAMINO REAL
CARLSBAD, CA 92008
0il/18/2023 ,. 14:02:37
CREDIT CARD
VISA COMPLETED SALE
card II
Olip card:
AID:
SEQ #:
ORJG PRE·AUTH SEQ#:
Batch r,:
INVOICE
' ~iproval Code:
En lry ~kithod:
Mc<le:
SAlE AMOUNT
~29 l/
CHASE VISi1
A00000000310!0
96
1010
71ti
92
026250
Contadits.;
l5Sller
CUSTOMER COPY
t 1. Ticket #: 2587978
PALOMAR TRANSFER
5960 EL CAMINO REAL
CARLSBAD , CA 92008 Weighrnaster : IN -martios3 OUT -macara
(760)603-0153
000999 -CASH AND CHECK CUSTOMER
ADDRESS
carlsbad, CA 92008
Contract : RESIDENTIAL-Yr . 2
GROSS 9, 920 Scale In
TARE 9 ,020 Scale Out
NET 900
Tracking Qty : 0 .00
Qty
0 .45
Unit Description
TN MSW
Origin : CARLSBAD
Signature :
100%
In : August 18 , 2023
Out : August 18 , 2023
Vehicle : CD
Ref : 9920/180CC
BOL :
INBOUND
CASH
Rate Extension Tax
$0 .00 $96 .28 $55 .00
Total
Paid
Change
.EDIT CARD-SCALE
1:23 pm
2 :02 pm
Total
$55 .00
$55 .00
$55 .00
$0 .00
V