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Home My WebLink About1735 CEREUS CT; ; CBR2025-1152; Recycle{ City of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN 8-59 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 EACH BOX ~ 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. 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 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. Signature of Applicant p Date:._...:.f_-_/_·_-Z.._o_1,_s ____ _ Page 1 of4 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 -I ±3tf: c.efl"~ c.our,t-APN Applicant Name ,?. IV l, i; J',t}11q) Phone 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 Carpet oors, Fixtures, circle all that apply) 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) t.S' 0 :t.o 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 □ 6g ~ gJ 5g □ □ □ □ flsl □ □ fgl □ ~ □ --=-I/'--, (-=--~----'x 0.65 = __ ],-;.•-=-(, ______ tons Total Estimated Waste from above Minimum Required Diversion Applic~tSignature V-f ...) ?-/ 7 Page 2 of4 Date __ ?.._~......:/c_~_u,_1.;_b-'---------- 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:...f? (l.._"7..:.) ~-I I <,2-Project Title ~---- Project Address l 1-'Z:7'5 Ce C'<-V7 '.zt: APN Applicant Name p.,..,,. '-vYl -<-r-W Phone bl'1-J<ol--{-1/ht> Last First 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 Example: 01/01/2020 SECTION C Material Type Concrete (broken) @TOTAL Diversion Rate Achieved Actual Amt Reused or Salvaged 30 /'t)o 0 Actual Amt Actual Amt Destination Facility Recycled Disposed in (Name, Address, Phone) Landfill Palomar Transfer Station, 5960 El 5 tons Camino Real -(760) 603-0153 (oo % 0 oa~ 0 0 0 = loo· % ----------Total of columns A + B Tot a I of columns A + B + C DIVERSION 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) 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 'PA.,.) 'I/ k-Date_J_tJ_._/_0_·_VJ_Z-S ___ _ Page 3 of 4 rev 4/24 ARCOS.\ DISPOSAL TICKET , ·' -:. -~ 8354 Nelson Way 760-205-1797 CRUSHED CONCRETE DATE: Escondido CA 92026 TICI<ET NO: 1984013911 CUSTOMER: TRUCK NO. COMMODITY: DISPOSAL RECEIPT 12171262-ACCLA 1984 ESCONDIDO CC NONT.A 0721001 PO: SUPER 10 LOAD ACE HAULING i2 EnergySurcharge-LA CUST JOB: COMMENTS: ACE HAULING i2 07210Ul PEDRO DRIVERS SIGNATURE DISPOSAL TICKET GROSS: TARE: NET: * P. a\RCOSA 8354 Nelson Way 760-205-1797 IQ!§ 0.00 16.82 0.00 T. CRUSHED CONCRETE Escondido CA 92026 TICI<ET NO: 1984013911 DISPOSAL RECEIPT CUSTOMER: TRUCK NO. COMMODITY: PO: CUST JOB: COMMENTS: 12171262-ACCLA 1984 ESCONDIDO CC NONT.A 0721001 SUPER 10 LOAD ACE HAULING i2 ACE HAULING i2 0721001 PEDRO DRIVERS SIGNATURE EnergySurcharge-LA IQ!§ GROSS: 0.00 TARE: 16.82 NET: 0.00 * P. T. * * DATE: 9/30/2025 TDCE: 8:25:37AM Super : 175.00 Other 5.00 Total 180.00 DATE: 9/30/2025 TIME: 8:25:37AM Super : 175.00 Other 5.00 Total 180.00 DISPOSAL TICKET 760-205-1797 CRUSHED CONCRETE DATE: 8354 Bel.son Way Escondido CA 92026 TICKET NO: 1984013690 CUSTOMER: TRUCK NO. COMMODllY: DISPOSAL RECEIPT 12171262-ACCLA 1984 ESCONDIDO CC NONT.A 07210Ul PO: SUPER 10 LOAD ACE HAULING ft2 EnergySurcharge-LA CUST JOB: COMMENTS: PEDRO 07210Ul ACE HAULING ft2 mt§ GROSS: 0.00 IIEJ:GIDQS'tBR &·e,.-. TARE: 16.82 NET: 0.00 * P. T. DRIVERS SIGNATURE DISPOSAL TICKET 8354 Bel.son Way 760-205-1797 CRUSHED CONCRETE Escondido CA 92026 TICKET NO: 1984013690 DISPOSAL RECEIPT CUSTOMER: TRUCK NO. COMMODITY: PO: CUST JOB: COMMENTS: IIEJ:GIDQffER &·e,.-. 12171262-ACCLA 1984 ESCONDIDO CC NONT.A 07210Ul SUPER 10 LOAD ACE HAULING #2 PEDRO 07210Ul ACE HAULING ft2 DRIVERS SIGNATURE EnergySurcharge-LA · mu GROSS: 0.00 TARE: 16.82 NET: 0.00 * P. T. DATE: 9/30/2025 TIME: 7:08:27AM Super • 175.00 * Other 5.00 Total 180.00 DATE: 9/30/2025 TIME: 7:08:27AM Super· 175.00 * Other 5.00 Total 180.00