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HomeMy WebLinkAbout1949 PALOMAR OAKS WAY; 100; CBC2018-0612; Permitcity of Carlsbad Commercial Permit Permit No: CBC2018-0612 Closed - Finaled 10/31/2018 03/05/2019 AKrog 3/29/2019 8:35:02AM Print Date: 03/29/2019 Job Address: 1949 Palomar Oaks Way, 100 Permit Type BLDG-Commercial Work Class: Tenant Improvement Status: Parcel No: 2130910100 Lot #: Applied: Valuation: $18,056.88 Reference #: Issued: Occupancy Group: Construction Type: Permit Finaled: It Dwelling Units: Bathrooms: Inspector: Bedrooms: Orig. Plan Check U: Final Plan Check U: Inspection: Project Title: Description: CRYTERION MEDICAL: 279 SF TI FOR CLEAN ROOM Applicant: Owner: Contractor: NUWAN RANASINGHE PALOMAR I LLC CLEAN ROOMS WEST INC 1945 Palomar Oaks Way 619-299-0011 CARLSBAD, CA 92011 1392 Industrial Dr Tustin, CA 92780-6416 714-258-7700 BUILDING PERMIT FEE ($2000+) $194.79 BUILDING PLAN CHECK FEE (BLDG) $136.35 ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL $41.00 FIRE Haz Mat Storage Chem Class 10-25 Chems $756.00 FIRE Plan Resub (3rd&Subsequent Submittal/hr) $340.00 FIRE Plan Review Per Hour - Office Hours . $204.00 MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL $39.00 5B1473 GREEN BUILDING STATE STANDARDS FEE $1.00 STRONG MOTION-COMMERCIAL $5.06 Total Fees: $1,717.20 Total Payments To Date: $1,717.20 . Balance Due: $0.00 Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure Will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project.NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. 1635 Faraday Avenue, Carlsbad, CA 92008-7314 1 760-602-2700 1 760-602-8560 f I www.carlsbadca.gov THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: DPLANNING DENGIWEERING OBUILOING OFIRE DIIEALTH DHAZMATIAPCD1 rP Building Permit Application Plan Check Noe20-. 0ki12_ City of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Cafisbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building©carlsbadca.gov Datelol-.341 19, Jswppp www.carlsbadca.gov JOB ADDRESS 1949 PALOMAR OAKS WAY I5UiTESPACE1,UN1flI I 100 I APH I 213 - 091 - 01 - 00 cr,paojccTe I.OTII PW15E5 IIOFUhIIS IT NANT BUSINESS NAME CONSTR. TYPE 0cC.GROUP I I I 11161101100NIS 1IIIIATKROOMS CRYTERION MEDICAL I DESCRIPTION OF WORK: include Square Feet of Affected Area(a) THIS PROJECT INCLUDES THE BUILD OUT OF A NEW CLEAN ROOM AT AN EXISTING TENANT IMPROVEMENT EXISTING USE PROPOSED USE E (SF) PATIOS(SF) I FIREPLACE I AIR CONDITIONING I FIRE SPRINKLERS BUSINESS I BUSINESS 1 GARAG 1101111 1DECKS(SFp JYEsD#. NOD YES DNOD I YESDNOD APPLICANT NAME Primary Contact NUWAN RANASINGHE PROPERTY OWNER NAME PALOMAR AQUISITIONS PARTNERS LLC ADDRESS 3900 FIFTH AVE SUITE 290 ADDRESS 525 B ST. SUITE 220 CITY STATE ZIP SAN DIEGO CA 92101 cliv STATE ZIP SAN DIEGO CA 92103 PHONE FAX FAX PHONE 6192990011 8584354026 I EMAIL EMAIL NUWAN@I)PDESIGNINC.COM DESIGN PROFESSIONAL CONTRACTOR BUS. NAME CLEAN ROOMS WEST, INC. ADDRESS ADDRESS 1392 INDUSTRIAL DR. CITY STATE ZIP / CITY TUSTIN STATE CA ZIP 92780 -- PHONE I - PHONE 714-258-7700 FAX 714-258-7777 EMAIL EMAIL KRISTEN@CLEANROOMSWEST.COM STME LIC.lI I CLASS CM BUS. 1.107650702(B I_BL0S1243481 ru .0 nus,nur,s .ini, rroivaswns ruuc; liny iiiy or ...uunly willen requires u purinic Weonsiruel, ulcer, Improve, aentuien or lepalr any structure, prior tons issuance, also requires the rrpptucanl for s,rch permit to file a signed stotoment that he Is licensed pursilani to the PlOVl5lflflS of the conlructor's License Leiw!Chnptcr 9, commending with Suction 700001 Division 301 lIce Business and Professions coda) or that he is exempt therefrom, and the basis for the alleged exemption. Any vintatinn at SectIon 7031.5 by any applicant for it permit subjects the applicant IOU sMI penalty or not more than fire hundred dollars ($500)). 'iieQlt" çt i 'ff.. I - "re S Workers' CompensatIon Declaration: Shore by affirm under penally of perjury one of lila following dcciaradons: 0 i have and will maintain a certificate of consent to sell-insure for workers colnpensolioll as provided by Section 3700 of the Labor Code. for the performance of the work for which this permit is Issued I have and will maintain workers' compensation, as required by Section 3700 of lire Labor Coda, for lire performance of the won For width this permit Is issued. My workers' compensation insurance career and policy numlieralo:lllslirarceCo.BERJ(SHIRE_HATHAWAY___ Policy filo...CLWC9243j7_ -_. Expi,alionDate 41112019__ lids section need not be completed if :ho permit is for one hundred dollars (SlOB) or loss. [J Certificate of Exemption: I certify that in the performance of the v,uic for which Ibis permit is Issued. I shall not employ any person in any manner so cola become sub,ecl 10 the Workels' Compensation Laws of Catfolnia WARNING: Failure to secue workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil tines up to one hundred thousand dollars (9100,000), In addition 101110 cost of compensation, d niagea as provided for in lion 370601 the Labor code, interest and attorney's tees. CONTRACTOR SIGNATURE []AGENT DATE 2/26/2019 I Ioreby offirm III.TI lam exom,pi from Conliaclor's license Law for file foill'r.vi,ig reason: 1. as owner of the properly or my employees wIth wages as their sole compensation, rail do the work and the slmclure is rol ictended or offered for son (Sec. 7044, Business and Professions Code: The Conhraclor's License Law dana not apply 10 an owner of property who builds or improves firemen, amid who does such work hiuntehl or ltvotrgh his own employees, provided that such Improvements are not inlcndcd or offered for sale If, however, the building or irr.prorerrenl is sold v.410n one year of completion, tl:c owner-builder will have the burden of proving that he did not (Mlii or improve for tIle purpose of sale) [] I, as owner of the properly, am euclusively, contracting w1h licensed contractors to construct tIle project (Sec. 1044. Business and Professions Code: The Conlracfoi's License Law does not apply loan owner of property who Iwduds or Improves Ihereon. and contracts for such projects vAh contractor(s) licensed pursuant to the Contractors License Law). [J lam exempt under Sestiorl ,_.,.,,,,,,,_,,...,.,..Business and Professions Code for lidS reason: I personally plan 10 preside the major labor and materials for construction of the proposed pioprlllyinprovelnenl. Dyes DWo I (liuvo! have not) signed on apphicalion for a budif tag permit for the proposed work. 11 have contracted with the following person (tint) to provide the proposed construction (include name address I phone I contractors' license number): 4. I plan 10 piovido pedors 01 the v.'orh, but I have lived the following person to coordinato, s4cc.4se and provide the mater work (include name i address ! phone I contractors' license number)' S. I will provide same of (e 501k, butt have contracted (hired) the following fmelsons 10 provide the work hirlicaled (indido name I address! phone! type of work): .'PR0PERTY OWNER SIGNATURE []AGENT DATE 7C003 1300() (POID IJ® ®011 1&)O'73 ®()t!S? Is the applicant or future building occupant required to submit business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No Is the facility to be constructed wIthin 1,000 feet of the outer boundary of school site? Yes No IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. (0 900) (}&)09 )®&W) I hereby affirm that there is a construction lending agency for the perfômiance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address O1? O0WO®J I cm*thatI have mad the application and statethatthe above information is conectand thatthe information on the plans Isaccurate. I agreeto compkwhh all C11yordinances and State laws relatingto buildingeonstructlon. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSD AGAINST ALL LIABIlITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA:- An OSHA permit is required for owadions am5' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every permit issued by to ilding 011ldal under the previsions of this Code shall expire by limitation and become null and void I lhe building or work authorized by such permits not commenced within l8o days from the date of such permit orif the build- g dc uthosized by itis suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). .APPIJCANVS SIGNATURE DATE /6 . /' /8 ¼ STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY lCommercial Projects Only) Fax (760) 602-8560, Email buildingcailsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME - ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANTS BUS. UC. No. DELIVERY OPI1ONS PICK UP: CONTACT (listed above) OCCUPANT (listed above) CONTRACTOR (On P. 1) ASSOCIATED CB# MAIL TO: CONTACT (listed above) OCCUPANT (Usted above) CONTRACTOR (On P& NO CHANGE IN USE / NO CONSTRUCTION MAIL/ FAX TO OTHER:________________________________ CHANGE OF USE/ NO CONSTRUCTION APPUCANVS SIGNATURE DATE Permit Type: BLDG-Commercial Application Date: 10/31/2018 Owner: PALOMAR I LLC Work Class: Tenant Improvement Issue Date: 03/05/2019 Subdivision: CARLSBAD TCT#80-38 Status: Closed - Finaled Expiration Date: 09/09/209 Address: 1949 Palomar Oaks Way, 100 Carlsbad, CA 92011-1312 IVR Number: 15038 Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Reunspection Complete Date Start Date 0310612019 0310612019 BLDG-15 085397.2019 Passed Andy Krogh Complete RooVReRoof (Patio) BLDG-84 Rough 085479-2019 Passed Andy Krogh Complete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 Yes Rough-Ducts-Dampers 0311212019 0311212019 BLDG-85 T-Bar, 085877-2019 Passed Andy Krogh Complete Ceiling Grids, Overhead Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 Yes Rough-Ducts-Dampers 03129I2019 0312912019 BLDG-Final 087327-2019 Passed Andy Krogh Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency i Yes BLDG-Plumbing Final Yes BLDG-Mechanical Final Yes BLDG-Structural Final Yes BLDG-Electrical Final Yes March 29, 2019 Page lof I EsGil A SAFEbuI1t Company DATE: 1/9/2019 0 APPLICANT U JURIS. JURISDICTION: Carlsbad PLAN CHECK #.: CBC2018-0612 SET: II PROJECT ADDRESS: 1949 Palomar Oaks Way #100 PROJECT NAME: Cryterion Tenant Improvement The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at EsGil until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. E The applicant's copy of the check list has been sent to: EsGil staff did not advise the applicant that the plan check has been completed. LII EsGil staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Email: Mail Telephone Fax In Person REMARKS:. Person in responsible control of the plans to sign sheetsçR-i through CRM-7 of both set I plans prior to permit issuance. ,. / ;/\ By: Jason Pasiut Enclosures: EsGil (1) 1/4/2019 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576 EsGil A SAFEbui1t:Company DATE: 11/7/2018 U APPLICANT J201URIS. JURISDICTION Carlsbad- PLAN CHECK #.: CBC2018-0612 SET:I PROJECT ADDRESS: 1949 Palomar Oaks Way #100 PROJECT NAME: Cryterion Tenant Improvement The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The Check list transmitted herewith is for your information. The plans are being held at EsGil until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for.the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: EsGil staff did not advise the applicant that the plan check has been completed. F-1 EsGil staff did advise the applicant that the plan check has been completed. Person contacted: -. Telephone #: Date contacted: (b) Email: Mail Telephone Fax In Person REMARKS: Person in responsible control of the plans to sign all sheets of both set I plans prior to permit issuance. By: Jason Pasiut Enclosures: EsGil 1.1/1/2018 9320 Chesapeake Drive, Suite 208 4 San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576 Carlsbad CBC2018-0612 11/7/2018 [DO NOT PAY — THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK #.: CBC2018-0612 PREPARED BY: Jason Pasiut DATE: 11/7/2018 BUILDING ADDRESS: 1949 Palomar Oaks Way #100 BUILDING OCCUPANCY: B BUILDING PORTION AREA (Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) TI 18,057 Air Conditioning Fire Sprinklers TOTAL VALUE 18,057 Jurisdiction Code Icb IBy Ordinance I 1997 UBC Building Permit Fee 1997 UBC Plan Check Fee Type of Review: LJ Complete Review 0 Structural Only O Repetitive Fee Repeats O Other O Hourly Hr. © * EsGII Fee I $118.601 Comments: Sheet of 1 acuity/Site :ryterion Medical Inc. - - CERS ID - - .949 Palomar Oaks Way Ste 100 10729900 arlsbad, CA 92011 ubmittal Status ubmitted on 8/29/2018 by Roel Cruz of Cryterion Medical Inc. (Carlsbad, CA) dentification :ryterlon Medical Inc. Beginning Date Ending Date )perator Phone Business Phone Business Fax 760) 206-7925 (760) 206-7925 Dun & Bradstreet SIC Code Primary NAICS 8731 541711 Facility/Site Mailing Address 949 Palomar Oaks Way Ste 100 - arisbad,CA92011 rimary Emergency Contact oel Cruz itle acility Engineer usiness Phone 24-Hour Phone Pager Number 760) 206-7925 (702) 677-0966 roel@cryterionmedicalco m )wner econdary Emergency Contact ryterion Medical Inc. uls Rodriguez 760)206-7910 -tie 949 Palomar Oaks Way Ste 100 production Manager arlsbad, CA 92011 lusiness Phone 24-Hour Phone Pager Number 787)688-9138 (631) 921-6820 luisrodriguez@bscicom illing Contact nvironmental Contact ania Cital oel Cruz 760) 206-7910 dcital@cryterionmedical.com 702)677-0966 roel@cryterionmedical.com L949 Palomar Oaks Way Ste 100 .949 Palomar Oaks Way Ste 100 :arlsbad, CA 92011 :arlsbad, CA 92011 lame of Signer Signer Title Document Preparer oel Cruz Facility Engineer Celeste Medina-Ontiveros dditional Information ly-collected Fields or all of the following fields may be required by your local regulator(s). 'roperty Owner 'alomar Creative, LLC 625-5276 Kearny Street Suite 600 Francisco, CA 94108 Assessor Parcel Number (APN) 213-091-0100 Number of Employees 35 Facility ID 37-000-003539 Printed on 10/31/2018 11:12 AM acuity/Site ryterion Medical Inc. - - CERSID 949 Palomar Oaks Way Ste 100 10729900 arisbad, CA 92011 ubmittal Status ibmitted on 8/29/2018 by Roe! Cruz of Cryterion Medical Inc. (Carlsbad, CA) Jentification ryterion Medical Inc. Beginning Date Ending Date perator Phone Business Phone Business Fax F60) 206-7925 (760) 206-7925 Dun & Bradstreet SIC Code Primary NAICS 8731 541711 Facility/Site Mailing Address 949 Palomar Oaks Way Ste 100 Carlsbad, CA 92011 Ii rimary Emergency Contact oel Cruz tle acuity Engineer usiness Phone 24-Hour Phone Pager Number 760) 206-7925 (702) 677-0966 roel@cryterionmedicalco m )wner condary Emergency Contact :ryterion Medical Inc. is Rodriguez 760) 206-7910 -tie lusiness .949 Palomar Oaks Way Ste 100 oduction Manager arisbad, CA 92011 Phone 24-Hour Phone Pager Number 1 787) 688-9138 (631) 921-6820 luisrodriguez@bscicom lling Contact nvironmental Contact nia Cital oel Cruz [7160)206-7910 dcital@cryterionmedical.com 702)677-0966 roeI@lcryterionmedical.com 49 Palomar Oaks Way Ste 100 949 Palomar Oaks Way Ste 100 rlsbad, CA 92011 arlsbad, CA 92011 ame of Signer Signer Title Document Preparer oel Cruz Facility Engineer Celeste Medina-Ontiveros ddidonal Information illy-collected Fields ----- e or all of the following fields may be required by your local regulator(s). Property Owner Palomar Creative, LIC )625-5276 ng Address Kearny Street Suite 600 Francisco, CA 94108 Assessor Parcel Number (APN) 213-091-0100 Number of Employees 35 Facility ID 37-000-003539 Printed on 10/31/2018 11:12 AM CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM (CERS) CONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLAN Prior to completing this Plan, please refer to the JNSTR UCTIONS FOR COMPLETING A CONSOLIDATED CONTTNGENCYPLAN A. FACILITY IDENTIFICATION AND OPERATIONS OVERVIEW FACILITY ID II A2. DATE OF PLAN PREPA.ATION/REVISION - - I r1-TCERSID # 10729900 (MM/DD/YYYY) 08/27/2018 BUSINESS NAME (Same as Facility Name orDBA - Doing Business As) A4. Cryterion Medical Inc. BUSINESS SITE ADDRESS 1949 Palomar Oaks Way Ste 100 BUSINESS SITE CITY A6. ZIP CODE A?. Carlsbad CA TYPE OF BUSINESS (e.g., Painting Contractor) AS. INCIDENTAL OPERATIONS (e.g., Fleet Maintenance) Medical Device Research and Development I THIS PLAN COVERS CHEMICAL SPILLS, FIRES, AND EARTHQUAKES INVOLVING (Check all that apply): AIO. [] 1. HAZARDOUS MATERIALS; [J 2. HAZARDOUS WASTES B. INTERNAL RESPONSE INTERNAL FACILITY EMERGENCY RESPONSE WILL OCCUR BY (Check all that apply): BI. CALLING PUBLIC EMERGENCY RESPONDERS (e.g., 9-1-1) CALLING HAZARDOUS WASTE CONTRACTOR 03. ACTIVATING IN-HOUSE EMERGENCY RESPONSE TEAM I C. EMERGENCY COMMUNICATIONS, PHONE NUMBERS AND NOTIFICATIONS I In the event of an emergency involving hazardous materials and/or hazardous waste, all facilities must IMMEDIATELY: Notify facility personnel and evacuate if necessary in accordance with the Emergency Action Plan (Title 8 California Code of Regulations §3220); Notify local emergency responders by calling 9-1-1; Notify the local Unified Program Agency (UPA) at the phone number below; and Notify the State Warning Center at (800) 852-7550. Facilities that generate, treat, store or dispose of hazardous waste have additional responsibilities to notify and coordinate with other response agencies. Whenever there is an imminent or actual emergency situation such as an explosion, fire, or release, the Emergency Coordinator must follow the appropriate requirements for the category of facility and type of release involved: Title 22 California Code of Regulations §66265.56. Emergency Procedures for generators of 1,000 kilograms or more of hazardous waste in any calendar month. Title 22 California Code of Regulations §66265.196. Response to Leaks or Spills and Disposition of Leaking or Unfit-for-Use Tank Systems. Title 40 Code of Federal Regulations §302.6. Notification requirements for a release of a hazardous substance equal to or greater than the reportable quantity. Title 22 California Code of Regulations §66262.34(d)(2) and Title 40 Code of Federal Regulations §262.34(d)(5)(ii) for generators of less than 1000 kilograms of hazardous waste in any calendar month. Following notification and before facility operations are resumed in areas of the facility affected by the incident, the Emergency Coordinator shall notify the local UPA and the local fire department's hazardous materials program, if necessary, that the facility is in compliance with requirements to: Provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release at the facility; and Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the facility affected by the incident until cleanup procedures are completed. EMERGENCY RESPONSE AMBULANCE, FIRE, POLICE AND CHP ..............................................9-1-1 PHONE NUMBERS: CALIFORNIA STATE WARNING CENTER (CSWC)/CAL OES ............................ (800) 852-7550 NATIONAL RESPONSE CENTER (NRC) ..............................................(800) 424-8802 POISON CONTROL CENTER ...................................................... ..(800) 222-1222 LOCAL UNIFIED PROGRAM AGENCY (UPA) .........................................(858) 505-6657 OTHER (Specify): JACTenviro (866) 333-9222 NEAREST MEDICAL FACILITY / HOSPITAL NAME: ITri-City Medical Center (760) 692-2900 AGENCY NOTIFICATION PHONE NUMBERS: CALIFORNIA DEPT. OF TOXIC SUBSTANCES CONTROL (DTSC) .... (916) 255-3545 REGIONAL WATER QUALITY CONTROL BOARD (RWQCB) ........ 1(619)516-1990 U.S. ENVIRONMENTAL PROTECTION AGENCY (US EPA) ...........(800) 300-2193 CALIFORNIA DEPT. OF FISH AND WILDLIFE (CDFW) ..............(916) 358-2900 U.S. COAST GUARD (USCG) .....................................(202) 267-2180 CAL OSHA .....................................................(916) 263-2800 CAL FIRE OFFICE OF THE STATE FIRE MARSHAL (OSFM) ....... .. (9i)323-7390 OTHER (Specify): L. .. OTHER (Specify): C9. Rev. 03/07117 Page 1 of 4 CERS Consolidated Emergency Response / Contingency Plan INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR BY (Check all that apply): CII. [] 1. VERBAL WARNINGS; 02. PUBLIC ADDRESS OR INTERCOM SYSTEM; 03. TELEPHONE; PAGERS; El 5. ALARM SYSTEM; 06. PORTABLE RADIO NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY (Check all that apply): C12. El 1. VERBAL WARNINGS; 02. PUBLIC ADDRESS OR INTERCOM SYSTEM; £13. TELEPHONE; 04. PAGERS; OS. ALARM SYSTEM; 06. PORTABLE RADIO EMERGENCY COORDINATOR CONTACT INFORMATION: Luis Rodriguez C13. PRIMARY EMERGENCY COORDINATOR NAME: Luis Rodriguez PHONE NO.: (787) 688-9138 PHONE NO.: (631) 921-6820 ALTERNATE EMERGENCY COORDINATOR NAME: Roel Cruz PHONE NO.: (702) 677-0966 PHONE NO.: (760) 586-2696 El Check if additional Emergency Coordinator contact and address information is available onsite or by calling PHONE NO.: Note: If more than one alternate emergency coordinator is designated, attach a list in order of responsibility. D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES Check the applicable boxes to indicate your facility's procedures for containing spills and preventing and mitigating releases, fires and/or explosions. DI. Dl. MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP, ETC.; 02. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e.g., Portable spill containment walls, built-in berms); El 3. PROVIDE ABSORBENT PHYSICAL BARRIERS (e.g., Pads, spill pigs, spill pillows); COVER OR BLOCK FLOOR AND/OR STORM DRAINS; LINED TRENCH DRAINS AND/OR SUMPS; El 6. AUTOMATIC FIRE SUPPRESSION SYSTEM; 0 7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS; El 8. STOP PROCESSES AND/OR OPERATIONS; 09. AUTOMATIC / ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM; SHUT OFF WATER, GAS, ELECTRICAL UTILITIES; CALL 9-1-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE AND/OR MEDICAL AID; NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AND/OR IMPACTED AREAS; ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION; PROVIDE PROTECTIVE EQUIPMENT FOR ON-SITE EMERGENCY RESPONSE TEAM; REMOVE CONTAINERS AND/OR ISOLATE AREAS; HIRE LICENSED HAZARDOUS WASTE CONTRACTOR; USE ABSORBENT MATERIAL FOR SPILL CONTAINMENT; VACUUM SUCTION USING APPROPRIATE VACUUM (e.g., Intrinsically safe) FOR SPILL CONTROL AND/OR CLEANUP; DECONTAMINATE PERSONNEL AND EQUIPMENT WITHIN DESIGNATED AREA AND DISPOSE OF WASTEWATER AS HAZARDOUS WASTE; El 20. PROVIDE SAFE TEMPORARY STORAGE OF HAZARDOUS WASTE GENERATED DURING EMERGENCY. ACTIONS; E] 21. OTHER (Specify): D2. E. FACILITY EVACUATION THE FOLLOWING ALARM SIGNAL(S) WILL BE USED TO BEGIN EVACUATION OF THE FACILITY (Check all that apply): El. BELLS; HORNS/SIRENS; VERBAL (i.e., Shouting); 04. OTHER (Specify): THE FOLLOWING LOCATION(S) WILL BE USED FOR AN EMERGENCY ASSEMBLY AREA(S) (e.g., Parking lot street corner): Parking Lot on south end of building. If an alternative location is required the employees will be instructed to relocate to a safe assembly point. Note: The Emergency Coordinator must account for all onsite employees and visitors after evacuation. EVACUATION ROUTE S AND ALTERNATE EVACUATION ROUTES ARE DESCRIBED AS FOLLOWS: E4. Dl. WRITTEN PROCEDURES DESCRIBING ROUTES, EXITS, AND ASSEMBLY AREAS; El 2. EVACUATION MAP(S) DEPICTING ROUTES, EXITS, AND ASSEMBLY AREAS; OTHER (Specify): as. Note: Evacuation procedures and/or maps should be posted in visible facility locations and must be included in the Contingency Plan. F. ARRANGEMENTS FOR EMERGENCY SERVICES ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (Check one of the following): Fl. El 1. HAVE BEEN DETERMINED NOT NECESSARY; F2. 02. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (Specify): Note: Advance arrangements with local fire and police departments, hospitals, state and local emergency response teams, and/or emergency services contractors should be made for your facility, if necessary. Large Quantity Generators must describe arrangements in the Contingency Plan. Rev. 03/07/17 Page 2 of 4 CERS Consolidated Emergency Response / Contingency Plan G. EMERGENCY EQUIPMENT Check the applicable boxes to list emergency response equipment available at the facility, identify the location(s) where the equipment is kept, and indicate the equipment's capability, if applicable. TYPE EQUIPMENT AVAILABLE GI. LOCATION 02 CAPABILITY 03. EXAMPLE Z CHEMICAL PROTECTIVE GLOVES SPILL RESPONSE KIT STNGLE USE, OIL RESISTANT ONLY Safety and [1 CHEMICAL PROTECTIVE SUITS, APRONS, AND/OR VESTS First Aid [] CHEMICAL PROTECTIVE GLOVES Throughout Lab areas 0 CHEMICAL PROTECTIVE BOOTS SAFETY GLASSES, GOGGLES, AND FACE SHIELDS Entrance of lab areas 0 HARD HATS 0 AIR-PURIFYING RESPIRATORS 0 SELF-CONTAINED BREATHING APPARATUS (SCBM [] FIRST AID KITS In breakroom 0 PLUMBED EYEWASH FOUNTAIN AND/OR SHOWER 0 PORTABLE EYEWASH KITS AND/OR STATION 0 OTHER Fire [] PORTABLE FIRE EXTINGUISHERS Throughout building Fighting [] FIXED FIRE SUPPRESSION SYSTEMS AND/ OR SPRINKLERS Throughout building 0 FIRE ALARM BOXES 0 OTHER Spill Control 0 ALL-IN-ONE SPILL KIT and fl ABSORBENT MATERIAL Clean-Up 0 CONTAINER FOR USED ABSORBENT [] BERM AND/OR DIKING EQUIPMENT 0 BROOM 0 SHOVEL 0 VACUUM (J EXHAUST HOOD Snorkel exhaust in lab area 0 SUMP AND/OR HOLDING TANK 0 CHEMICAL NEUTRALIZERS 0 GAS CYLINDER LEAK REPAIR KIT 0 SPILL OVERPACK DRUMS 0 OTHER Communi- cations El TELEPHONES (e.g., Cellular) Through building and 30.0 INTERCOM AND/OR PA SYSTEM Alarm 0 PORTABLE RADIOS Systems 0 AUTOMATIC ALARM CHEMICAL MONITORING EQUIPMENT Other 0 OTHER 0 OTHER Rev. 03/07117 Page 3 of 4 CERS Consolidated Emergency Response I Contingency Plan H. EARTHQUAKE VULNERABILITY Identify areas of the facility that are vulnerable to hazardous materials releases due to seismic motion. These areas require immediate isolation and inspection. VULNERABLE AREAS (Check all that apply): H1. LOCATIONS (e.g., Shop, outdoor shed, lab): H2. El 1. HAZARDOUS MATERIALS AND/OR WASTE STORAGE AREAS Lab areas and warehouse 0 2. PROCESS LINES AND PIPING El 3. LABORATORY Lab area 0 4. WASTE TREATMENT AREA Identify mechanical systems vulnerable to releases / spills due to earthquake-related motion. These systems require immediate isolation and inspection. VULNERABLE SYSTEMS AND/OR EQUIPMENT (Check all that apply): an LOCATIONS: H4. El I. SHELVES, CABINETS AND/OR RACKS Throughout building 2. TANKS AND SHUT-OFF VALVES PORTABLE GAS CYLINDERS Throughout building and warehouse EMERGENCY SHUT-OFF AND/OR UTILITY VALVES Front of building Building by front entrance in separate enclosure accessible from SPRINKLER SYSTEMS interior 6. STATIONARY PRESSURIZED CONTAINERS (e.g., Propane tank) I. EMPLOYEE TRAINING Employee training is required for all employees and/orcontractors handling hazardous materials and/or hazardous wastes during nonnál and/or emergency operations. Most facilities will need to submit a separate Training Plan. However, your CUPA may accept this section as the Training Plan for some small facilities. Employee training plans may include the following content: Applicable laws and regulations; • Communication and alarm systems; Emergency response plans and procedures; • Personal protective equipment; Safety Data Sheets; . Use and maintenance of emergency response equipment and supplies Hazard communication related to health and safety; (e.g. Fire extinguishers, respirators, spill control materials); Methods for safe handling of hazardous substances; • Decontamination procedures; Hazards of materials and processes (e.g., fire, explosion, asphyxiation); • Evacuation procedures and evacuation staging locations; Hazard mitigation, prevention and abatement procedures; • Identification of facility areas, equipment, and systems vulnerable to Coordination of emergency response actions; earthquakes and other natural disasters. Notification procedures for local emergency responders, CUPA, • OTHER (Specify): Pe Cal OES, and onsite personnel; Check the applicable boxes below to indicate how the employee training program is administered. Ell. FORMAL CLASSROOM El 2. VIDEOS El 3. SAFETY MEETINGS 04. STUDY GUIDES /MANUALS El S. OTHER (Specify): 12. NOT APPLICABLE SINCE FACILITY HAS NO EMPLOYEES CHECK IF A SEPARATE EMPLOYEE TRAINING PLAN IS USED AND UPLOADED TO CERS AS A PDF DOCUMENT 13. 14. CHECK IF EMPLOYEE TRAINING IS COVERED BY THE ABOVE REFERENCED CONTENT AND OTHER DOCUMENTS ONSITE EMPLOYEE TRAINING FREQUENCY AND RECORDKEEPING TRAINING MUST BE: Provided initially for new employees as soon as possible following the date of hire. New employees should not work in an unsupervised position that involves hazardous materials handling and/or hazardous waste management without proper training; Provided within six months from the date of hire for new employees at a large quantity generator; Ongoing and provided at least annually; Amended prior to a change in process or work assignment; Given upon modification to the Emergency Response/Contingency Plan. Large Quantity Generator Training: Large quantity generators (1,000 kg or more) must retain written plan and documentation of employee training which includes: A written description of the type and amount Qf both initial and ongoing training that will be given to persons filling each job position having responsibility for hazardous waste management and/or emergency response. The name, job title and job description for each position at the facility related to hazardous waste management Current employee training records must be retained until closure of the facility and former employee training records must be retained for at least three years after termination of employment. Small Quantity Generator Training: Small quantity generators (less than 1,000 kg) must include basic hazardous waste management and emergency response procedures but a written employee training plan and training records are not required. In order to show that the facility has met the small quantity generator employee training requirement, an employee training plan and training records may be made available. Hazardous Materials Business Plan Training: Businesses must provide initial and annual employee training that includes the content referenced above. The training may be based on the job position and training records must be made available for a period of at least three years. J. LIST OF ATTACHMENTS Check one of the following: ii. El 1. NO ATTACHMENTS ARE REQUIRED; or 02. THE FOLLOWING DOCUMENTS ARE ATTACHED:. 12. Rev. 03/07/17 Page 4 of 4 BusIness/Org. Cryterion Medical Inc. chemical Location lyName Cryterion Medical Inc. See Site Map 1949 Palomar Oaks Way Ste 100, Carlsbad 92011 -. - Annual Quantities Waste Federal Hazard ode/Fire Haz. Class Common Name Unit Max. Daily Largest Cont. Avg. Daily Amount Categories 6.2- Infectious Substances BIOHAZARDOUS RED BAG WASTE Pounds 20 - 5 10 40 - Health Acute CAS No State Storage Container Pressue Waste Code Toxicity Solid Bag, Tote Bin Ambient 322 Lp_ Temperature Waste Days on Site: 365 Ambient 6.2-Infectious Substances Biohazardous Sharps Waste Pounds 4 2 2 16 - Health Acute CAS No State Storage Container Pressue Waste Code Toxicity Solid Other Ambient 322 Type Temperature Waste Days on Site: 365 Ambient 3-Flammable and FLAMMABLE LIQUID WASTE Gallons 2 2 1 10 - Physical ustible Liquids SOLVENTS Storage Container Pressue Flammable Liquid Carboy Ambient Waste Code - Health Acute mable Liquid, Class I-B CAS No IYL Temperature_ 212 Toxicity Waste Days on Site: 365 Ambient CEBS ID 10729900 Facility ID 37-000-003539 Status Submitted on 8/29/2018 7:25 AM Hazardous Components (For mixture only) Component Name % Wt EHS CAS No. Acetone 25% 67-64-1 Isopropyl alcohol 25% 67-63-0 Water 50% 7732-18-5 Printed on 10/31/2018 12:55 PM Page 1 of 2 Chemical Location CERS ID 10729900 Warehouse and Laboratories Facility ID 37-000-003539 Status Submitted on 8/29 Annual Hazardous Components Quantities Waste Federal Hazard (For mixture only) Unit Max. Daily Largest Cont. Avg. Daily Amount Categories Component Name % Wt Pounds 10 10 5 20 -Physical Isopropyl Alcohol 1% State Storage Container Pressue Waste Code Flammable Ethyl Alcohol 67% Solid Plastic/Non-metalic Drum, Can Ambient 352 Deionized Water 30% IY2_. Temperature Methanol 3% Waste Days on Site: 365 Ambient Cu. Feet 1000 558 600 0 - Physical Gas State Storage Container Pressue Waste Code Under Pressure Gas Cylinder >Ambient Type Temperature Pure Days on Site: 365 Ambient Cu. Feet 4200 558 1200 0 - Physical Gas State Storage Container Pressue Waste Code Under Pressure Gas Cylinder > Ambient - Physical Oxidizer Type Temperature - Pure Days on Site: 365 Ambient Business/Org. Cryterion Medical Inc. LV Name Cryterion Medical Inc. 1949 Palomar Oaks Way Ste 100, Carlsbad 92011 ode/Fire Haz. Class Common Name 4.1- Flammable Solids Alcohol Wipes nable Solid, Flammable CAS No 2.2- Nonflammable Gases Nitrogen CAS No 7727-37-9 2.2- Nonflammable Gases Nitrous Oxide ting Gas. Gaseous CAS No 10024-97-2 7:25 EHS CAS No. 67-63-0 64-17-5 7732-18-5 67-56-1 Printed on 10/31/2018 12:55 PM Page 2 of 2 CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM (CERS) CONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLAN Prior to completing this Plan, please refer to the INSTRUCTIONS FOR COMPLETiNG A CONSOLIDATED CONTINGENCYPLAN A. FACILITY IDENTIFICATION AND OPERATIONS OVERVIEW FACILITY ID # CERS ID # A2. DATE OF PLAN PREPARATION/REVISION - - ri. I 10729900 (MM/DDIYYYY) 08/27/2018 BUSINESS NAME (Same as Facility Name orDBA - Doing Business As) A4. Cryterion Medical Inc. BUSINESS SITE ADDRESS AS. 1949 Palomar Oaks Way Ste 100 BUSINESS SITE CITY AS. ZIP CODE A7. Carlsbad CA TYPE OF BUSINESS (e.g., Painting Contractor) A8. INCIDENTAL OPERATIONS (e.g., Fleet Maintenance) A9. Medical Device Research and Development I THIS PLAN COVERS CHEMICAL SPILLS, FIRES, AND EARTHQUAKES INVOLVING (Check all that apply): AIO. [] 1. HAZARDOUS MATERIALS; [] 2. HAZARDOUS WASTES B. INTERNAL RESPONSE INTERNAL FACILITY EMERGENCY RESPONSE WILL OCCUR BY (Check all that apply): BI. CALLING PUBLIC EMERGENCY RESPONDERS (e.g., 9-1-1) CALLING HAZARDOUS WASTE CONTRACTOR D 3. ACTIVATING IN-HOUSE EMERGENCY RESPONSE TEAM C. EMERGENCY COMMUNICATIONS, PHONE NUMBERS AND NOTIFICATIONS In the event of an emergency involving hazardous materials and/or hazardous waste, all facilities must IMMEDIATELY: Notify facility personnel and evacuate if necessary in accordance with the Emergency Action Plan (Title 8 California Code of Regulations §3220); Notify local emergency responders by calling 9-1-1; Notify the local Unified Program Agency (UPA) at the phone number below; and Notify the State Warning Center at (800) 852-7550. Facilities that generate, treat, store or dispose of hazardous waste have additional responsibilities to notify and coordinate with other response agencies. Whenever there is an imminent or actual emergency situation such as an explosion, fire, or release, the Emergency Coordinator must follow the appropriate requirements for the category of facility and type of release involved: Title 22 California Code of Regulations §66265.56. Emergency Procedures for generators of 1,000 kilograms or more of hazardous waste in any calendar month. Title 22 California Code of Regulations §66265.196. Response to Leaks or Spills and Disposition of Leaking or Unfit-for-Use Tank Systems. Title 40 Code of Federal Regulations §302.6. Notification requirements for a release of a hazardous substance equal to or greater than the reportable quantity. Title 22 California Code of Regulations §66262.34(d)(2) and Title 40 Code of Federal Regulations §262.34(d)(5)(ii) for generators of less than 1000 kilograms of hazardous waste in any calendar month. Following notification and before facility operations are resumed in areas of the facility affected by the incident, the Emergency Coordinator shall notify the local UPA and the local fire department's hazardous materials program, if necessary, that the facility is in compliance with requirements to: Provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release at the facility; and Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the facility affected by the incident until cleanup procedures are completed. EMERGENCY RESPONSE AMBULANCE, FIRE, POLICE AND CHP ..............................................9-I-I PHONE NUMBERS: CALIFORNIA STATE WARNING CENTER (CSWC)/CAL OES............................(800) 852-7550 NATIONAL RESPONSE CENTER (NRC) ..............................................(800) 424-8802 POISON CONTROL CENTER........................................................(800) 222-1222 LOCAL UNIFIED PROGRAM AGENCY (UPA) ..........................................(858) 505-6657 C" OTHER (Specify): l C3. ACTenviro C2. (866) 333-9222 NEAREST MEDICAL FACILITY /HOSPITAL NAME: Tri-City Medical Center C4. (760) 692-2900 C5 AGENCY NOTIFICATION PHONE NUMBERS: CALIFORNIA DEPT. OF TOXIC SUBSTANCES CONTROL (DTSC) .... (916)25 - A R REGIONAL WATER QUALITY CONTROL BOARD (RWQCB)........1(619) 516-1990 U.S. ENVIRONMENTAL PROTECTION AGENCY (US EPA) ...........(800) 300-2193 CALIFORNIA DEPT. OF FISH AND WILDLIFE (CDFW) ..............(916) 358-2900 U.S. COAST GUARD (USCG) .....................................(202) 267-2180 CAL OSHA .....................................................(916) 263-2800 CAL FIRE OFFICE OF THE STATE FIRE MARSHAL (OSFM) .........(916) 323-7390 OTHER (Specify): [,__ OTHER (Specify): C9. 1 CIO. Rev. 03/07/17 Page 1 of 4 CERS Consolidated Emergency Response / Contingency Plan INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR BY (Check all that apply): CII. El 1. VERBAL WARNINGS; 02. PUBLIC ADDRESS OR INTERCOM SYSTEM; 03. TELEPHONE; 04. PAGERS; El 5. ALARM SYSTEM; 06. PORTABLE RADIO NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY (Check all that apply): C12. El 1. VERBAL WARNINGS; 02. PUBLIC ADDRESS OR INTERCOM SYSTEM; 03. TELEPHONE; 04. PAGERS; 0 S. ALARM SYSTEM; 06. PORTABLE RADIO EMERGENCY COORDINATOR CONTACT INFORMATION: Luis Rodriguez C13. PRIMARY EMERGENCY COORDINATOR NAME: Luis Rodriguez PHONE NO.: (787) 688-9138 PHONE NO.: (631) 921-6820 ALTERNATE EMERGENCY COORDINATOR NAME: Roe[ Cruz PHONE NO.: (702) 677-0966 PHONE NO.: (760) 586-2696 D Check if additional Emergency Coordinator contact and address information is available onsite or by calling PHONE NO.: Note: If more than one alternate emergency coordinator is designated, attach a list in order of responsibility. D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES Check the applicable boxes to indicate your facility's procedures for containing spills and preventing and mitigating releases, fires and/or explosions. Dl. 1. MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP, ETC.; 0 2. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e.g., Portable spill containment walls, built-in berms); PROVIDE ABSORBENT PHYSICAL BARRIERS (e.g., Pads, spill pigs, spill pillows); COVER OR BLOCK FLOOR AND/OR STORM DRAINS; LINED TRENCH DRAINS AND/OR SUMPS; AUTOMATIC FIRE SUPPRESSION SYSTEM; ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS; STOP PROCESSES AND/OR OPERATIONS; 09. AUTOMATIC / ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM; SHUT OFF WATER, GAS, ELECTRICAL UTILITIES; CALL 9-1-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE AND/OR MEDICAL AID; NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AND/OR IMPACTED AREAS; ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION; 14. PROVIDE PROTECTIVE EQUIPMENT FOR ON-SITE EMERGENCY RESPONSE TEAM; REMOVE CONTAINERS AND/OR ISOLATE AREAS; HIRE LICENSED HAZARDOUS WASTE CONTRACTOR; 17. USE ABSORBENT MATERIAL FOR SPILL CONTAINMENT; 18. VACUUM SUCTION USING APPROPRIATE VACUUM (e.g., Intrinsically safe) FOR SPILL CONTROL AND/OR CLEANUP; 019. DECONTAMINATE PERSONNEL AND EQUIPMENT WITHIN DESIGNATED AREA AND DISPOSE OF WASTEWATER AS HAZARDOUS WASTE; El 20. PROVIDE SAFE TEMPORARY STORAGE OF HAZARDOUS WASTE GENERATED DURING EMERGENCY ACTIONS; 21. OTHER (Specify): D2. E. FACILITY EVACUATION THE FOLLOWING ALARM SIGNAL(S) WILL BE USED TO BEGIN EVACUATION OF THE FACILITY (Check all that apply): El. BELLS; E2. HORNS/SIRENS; VERBAL (i.e., Shouting); 04. OTHER (Specify): THE FOLLOWING LOCATION(S) WILL BE USED FOR AN EMERGENCY ASSEMBLY AREA(S) (e.g., Parking lot street corner): E3. Parking Lot on south end of building. If an alternative location is required the employees will be instructed to relocate to a safe assembly point. Note: Tle Emergency Coordinator must account for all onsite employees and visitors after evacuation. EVACUATION ROUTES AND ALTERNATE EVACUATION ROUTES ARE DESCRIBED AS FOLLOWS: E4. Di. WRITTEN PROCEDURES DESCRIBING ROUTES, EXITS, AND ASSEMBLY AREAS; EVACUATION MAP(S) DEPICTING ROUTES, EXITS, AND ASSEMBLY AREAS; 03. OTHER (Specify): E5. Note: Evacuation procedures and/or maps should be posted in visible facility locations and must be included in the Contingency Plan. F. ARRANGEMENTS FOR EMERGENCY SERVICES ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (Check one of the following): Fl. El 1. HAVE BEEN DETERMINED NOT NECESSARY; 02. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (Specify): F2. Note: Advance arrangements with local fire and police departments, hospitals, state and local emergency response teams, and/or emergency services contractors should be made for your facility, if necessary. Large Quantity Generators must describe arrangements in the Contingency Plan. Rev. 03/07/17 Page 2 of 4 CERS Consolidated Emergency Response I Contingency Plan G. EMERGENCY EQUIPMENT Check the applicable boxes to list emergency response equipment available at the facility, identify the location(s) where the equipment is kept, and indicate the equipment's capability, if applicable. TYPE EQUIPMENT AVAILABLE ci. LOCATION 02. CAPABILITY G3. EXAMPLE II CHEMICAL PROTECTIVE GLOVES SPILL RESPONSE KIT SINGLE USE, OIL RESISTANT ONLY Safety and 0 CHEMICAL PROTECTIVE SUITS, APRONS, AND/OR VESTS First Aid [] CHEMICAL PROTECTIVE GLOVES Throughout Lab areas 0 CHEMICAL PROTECTIVE BOOTS (J SAFETY GLASSES, GOGGLES, AND FACE SHIELDS Entrance of lab areas 0 HARD HATS 0 AIR-PURIFYING RESPIRATORS 0 SELF-CONTAINED BREATHING APPARATUS (SCBA) [J FIRST AID KITS In breakroom 0 PLUMBED EYEWASH FOUNTAIN AND/OR SHOWER 0 PORTABLE EYEWASH KITS AND/OR STATION Ii. 0 OTHER Fire Fighting [] PORTABLE FIRE EXTINGUISHERS Throughout building E] FIXED FIRE SUPPRESSION SYSTEMS AND/ OR SPRINKLERS Throughout building 0 FIRE ALARM BOXES 0 OTHER Spill Control 0 ALL-IN-ONE SPILL KIT and 17.[] ABSORBENT MATERIAL Clean-Up 18.0 CONTAINER FOR USED ABSORBENT 0 BERM AND/OR DIKING EQUIPMENT 0 BROOM 0 SHOVEL 0 VACUUM El EXHAUST HOOD Snorkel exhaust in lab area 24.0 SUMP AND/OR HOLDING TANK 0 CHEMICAL NEUTRALIZERS 0 GAS CYLINDER LEAK REPAIR KIT 27.[] SPILL OVERPACK DRUMS 0 OTHER Communi- cations J TELEPHONES (e.g., Cellular) Through building and 30.[] INTERCOM AND/OR PA SYSTEM Alarm 31.0 PORTABLE RADIOS Systems 32.0 AUTOMATIC ALARM CHEMICAL MONITORING EOUIPMENT Other 33.0 OTHER 34. 0 OTHER Rev. 03/07/17 Page 3 of 4 CERS Consolidated Emergency Response / Contingency Plan H. EARTHQUAKE VULNERABILITY Identify areas of the facility that are vulnerable to hazardous materials releases due to seismic motion. These areas require immediate isolation and inspection. VULNERABLE AREAS (Check all that apply): HI. LOCATIONS (e.g., Shop, outdoor shed, lab): H2. El 1. HAZARDOUS MATERIALS AND/OR WASTE STORAGE AREAS Lab areas and warehouse 0 2. PROCESS LINES AND PIPING LABORATORY . Lab area 0 4. WASTE TREATMENT AREA Identify mechanical systems vulnerable to releases / spills due to earthquake-related motion. These systems require immediate isolation and inspection. VULNERABLE SYSTEMS AND/OR EQUIPMENT (Check all that apply): H3. LOCATIONS: 114. El 1. SHELVES, CABINETS AND/OR RACKS Throughout building C1 2. TANKS AND SHUT-OFF VALVES 3. PORTABLE GAS CYLINDERS 'Throughout building and warehouse EMERGENCY SHUT-OFF AND/OR UTILITY VALVES Front of building SPRINKLER SYSTEMS Building by front entrance in separate enclosure accessible from 6. STATIONARY PRESSURIZED CONTAINERS (e.g., Propane tank) interior I. EMPLOYEE TRAINING Employee training is required for all employees and/orcontractors handling hazardous materials and/or hazardous wastes during normal and/or emergency operations: Most facilities will need to submit a separate Training Plan. However, your CUPA may accept this section as the Training Plan for some small facilities. Employee training plans may include the following content Applicable laws and regulations; • Communication and alarm systems; Emergency response plans and procedures; • Personal protective equipment; Safety Data Sheets; • Use and maintenance of emergency response equipment and supplies Hazard communication related to health and safety; (e.g. Fire extinguishers, respirators, spill control materials); Methods for safe handling of hazardous substances; • Decontamination procedures; Hazards of materials and processes (e.g., fire, explosion, asphyxiation); • Evacuation procedures and evacuation staging locations; Hazard mitigation, prevention and abatement procedures; • Identification of facility areas, equipment, and systems vulnerable to Coordination of emergency response actions; earthquakes and other natural disasters. Notification procedures for local emergency responders, CUPA, • OTHER (Specify): Cal OES, and onsite personnel; Check the applicable boxes below to indicate how the employee training program is administered. El 1. FORMAL CLASSROOM El 2. VIDEOS El 3. SAFETY MEETINGS 04. STUDY GUIDES / MANUALS fl 5. OTHER (Specify): 12. NOT APPLICABLE SINCE FACILITY HAS NO EMPLOYEES CHECK IF A SEPARATE EMPLOYEE TRAINING PLAN IS USED AND UPLOADED TO CERS AS A PDF DOCUMENT 13. CHECK IF EMPLOYEE TRAINING IS COVERED BY THE ABOVE REFERENCED CONTENT AND OTHER DOCUMENTS ONSITE 14 EMPLOYEE TRAINING FREQUENCY AND RECORDKEEPING TRAINING MUST BE: Provided initially for new employees as soon as possible following the date of hire. New employees should not work in an unsupervised position that involves hazardous materials handling and/or hazardous waste management without proper training; Provided within six months from the date of hire for new employees at a large quantity generator; Ongoing and provided at least annually; Amended prior to a change in process or work assignment; Given upon modification to the Emergency Response/Contingency Plan. Large Quantity Generator Training: Large quantity generators (1,000 kg or more) must retain written plan and documentation of employee training which includes: A written description of the type and amount of both initial and ongoing training that will be given to persons filling each job position having responsibility for hazardous waste management and/or emergency response. The name, job title and job description for each position at the facility related to hazardous waste management. Current employee training records must be retained until closure of the facility and former employee training records must be retained for at least three years after termination of employment. Small Quantity Generator Training: Small quantity generators (less than 1,000 kg) must include basic hazardous waste management and emergency response procedures but a written employee training plan and training records are not required. In order to show that the facility has met the small quantity generator employee training requirement, an employee training plan and training records may be made available. Hazardous Materials Business Plan Training: Businesses must provide initial and annual employee training that includes the content referenced above. The training may be based on the job position and training records must be made available for a period of at least three years. J. LIST OF ATTACHMENTS Check one of the following: ii. El 1. NO ATTACHMENTS ARE REQUIRED; or 02. THE FOLLOWING DOCUMENTS ARE ATTACHED: 12. Rev. 03/07/17 Page 4 of 4 Hazardous Materials And Wastes Inventory Matrix Report :ERs Business/Org. Cryterion Medical Inc. Chemical Location CERS ID 10729900 Facility Name Cryterion Medical Inc. See Site Map - Facility ID 37-000-003539 1949 Palomar Oaks Way Ste 100, Carlsbad 92011 Status Submitted on 8/29/2018 7:25 AM Annual Hazardous Components Quantities Waste Federal Hazard (For mixture only) DOT Code/Fire Has. Class Common Name Unit Max. Daily Largest Cont. Avg. Daily Amount Categories Component Name Wt -% EHS CAS No. )OT: 6.2- Infectious Substances BIOHAZARDOLJS RED BAG WASTE Pounds 20 - 5 10 40 - Health Acute CAS No State Storage Container Pressue Waste Code Toxicity Solid Bag, Tote Bin Ambient 322 Type Temperature Waste Days on Site: 365 Ambient )OT: 6.2- infectious Substances Biohazardous Sharps Waste Pounds 4 2 2 16 - Health Acute CAS No State Storage Container -- Pressue Waste Code Toxicity Solid Other Ambient 322 . Type Temperature - Waste Days on Site: 365 Ambient DOT:3- Flammable and FLAMMABLE LIQUID WASTE Gallons 2 2 1 10 -Physical Acetone. 25% 67-64-1 :ombustible Liquids SOLVENTS Storage Container Pressue Flammable Liquid Carboy Ambient Waste Code - Health Acute Isopropyl alcohol 25% 67-63-0 :lammable Liquid, Class 1B CAS No Type Temperature 212 Toxicity Water 50% 7732-18-5 Waste Days on Site: 365 - Ambient - Printed on 10/31/2018 12:55 PM Page 1of2 Hazardous Materials And Wastes Inventory Matrix Report Business/Org. Cryterion Medical Inc. Chemical Location CERS ID 10729900 Facility Name Cryterion Medical Inc. Warehouse and Laboratories Facility ID 37-000-003539 1949 Palomar Oaks Way Ste 100, Carlsbad 92011 - Status Submitted On 8/29/2018 7:25 AM Annual Hazardous Components Quantities Waste Federal Hazard (For mixture only) DOT Code/Fire Has. Class Common Name Unit Max. Daily Largest Cont. Avg. Daily Amount Categories Component Name % Wt EHS CAS No. )OT: 4.1- Flammable Solids Alcohol Wipes Pounds 10 10 5 20 - Physical Isopropyl Alcohol 1% 67-63-0 lammable Solid, Flammable CAS No State Storage Container Pressue Waste Code Flammable Ethyl Alcohol 67% 64-17-5 olid Solid Plastic/Non-metalic Drum, Can Ambient 352 Deionized Water 30% 7732-18-5 I12L. Temperature Methanol 3% 67-56-1 Waste Days on Site: 365 Ambient )OT: 2.2- Nonflammable Gases Nitrogen Cu. Feet 1000 558 600 0 - Physical Gas CAS No State Storage Container Pressue - Waste Code Under Pressure 7727-37-9 Gas Cylinder > Ambient Type Temperature Pure Days on Site: 365 Ambient DOT: 2.2- Nonflammable Gases Nitrous Oxide Cu. Feet 4200 558 1200 0 - Physical Gas CAS N0 State-- Storage Container Pressue Waste Code Under Pressure Oxidizing Gas, Gaseous 10024-97-2 Gas Cylinder - > Ambient - Physical Oxidizer Type Temperature Pure Days on Site: 365 Ambient Printed on 10/31/2018 12:55 PM - Page 2of2 [ adlity/Site rion Medical Inc. cuts ID alomar Oaks Way Ste 100 10729900 d, CA 92011 ubmittal Status ubmitted on 8/29/2018 by Roel Cruz of Cryterion Medical Inc. (Carlsbad. CA) dentification :ryterion Medical Inc. Beginning Date Ending Date iperator Phone Business Phone Business Fax 760) 206-7925 (760) 206-7925 Dun & Bradstreet SIC Code Primary NAIS 8731 541711 aC uity/Site Mailing Address 949 Palomar Oaks Way Ste 100 r1sbad, CA 92011 primary Emergency Contact loel Cruz ie acuity Engineer lusiness Phone 24-Hour Phone Pager Number 760)206-7925 (702) 611-0966 roel@cryterionmedicalco M Iwner condary Emergency Contact ryterion Medical Inc. ls Rodriguez 760) 206-7910 le lusiness 949 Palomar Oaks Way Ste 100 oduction Manager arisbad, CA 92011 Phone 24-How Phone Pager Number 787) 688-9138 (631) 921-6820 Iuisrodriguez@bscicom lilling Contact nvironmental Contact lania Cital oel Cruz 760)206-7910 dcital@cryterionmedical.com [702)677-0966 roel@cryterionmedical.com .949 Palomar Oaks Way Ste 100 49 Palomar Oaks Way Ste 100 rlsbad, CA 92011 rlsbad, CA 92011 lame of Signer Signer Title Document Preparer oel Cruz Facility Engineer Celeste Medina-Ontiveros dditional information ly-collected Fields or all of the following fields may be required by your local regulator(s). roperty Owner alomar Creative, LLC hone 858) 625-5276 iailing Address 22 Kearny Street Suite 600 an Francisco, CA 94108 Assessor Parcel Number (APN) 213-091-0100 Number of Employees 35 Facility ID 37-000-003539 Printed on 10/31/2018 11:12 AM acuity/Site :ryterion Medical Inc. ERS ID 949 Palomar Oaks Way Ste 100 10729900 :arlsbad, CA 92011 ubmittal Status ubmitted on 8/29/2018 by Roel Cruz of Cryterion Medical Inc. (Carlsbad, CA) dentification :ryterion Medical Inc. Beginning Date Ending Date Iperator Phone Business Phone Business Fax 760) 206-7925 (760) 206-7925 Dun & Bradstreet SIC Code Primary NAICS 8731 541711 Facility/Site Mailing Address 949 Palomar Oaks Way Ste 100 arisbad, CA 92011 rimary Emergency Contact oel Cruz itle acility Engineer usiness Phone 24-Hour Phone Pager Number 760)206-7925 (702) 677-0966 roel@cryterionmedicalco m )wner Emergency Contact :ryterion Medical Inc. s Rodriguez 760) 206-7910 [econdary e .949 Palomar Oaks Way Ste 100 duction Manager :arlsbad, CA 92011 iness Phone 24-Hour Phone Pager Number 787) 688-9138 (631) 921-6820 luisrodriguez@bscicom hung Contact Contact ania Cital el Cruz 760) 206-7910 dcital@cryterionmedical.com [nvironmental 2) 677-0966 roel@cryterionmedicaLcom 949 Palomar Oaks Way Ste 100 9 Palomar Oaks Way Ste 100 r1sbad, CA 92011 lsbad, CA 92011 lame of Signer signerTitle Document Preparer oel Cruz Facility Engineer Celeste Medina-Ontiveros dditional Information ly-collected Fields - or all of the following fields may be required by your local regulator(s). roperty Owner alomar Creative, LIC hone 858) 625-5276 Wailing Address 22 Kearny Street Suite 600 an Francisco, CA 94108 Assessor Parcel Number (APN) 213-091-0100 Number of Employees 35 Facility ID 37-000-003539 Printed on 10/31/2018 11:12 AM HAZMAT TECHNICAL REPORT CRYTERION MEDICAL 1949 PALOMAR OAKS WAY, SUITE 100 CARLSBAD. CA 92011 Cryterion Medical, Inc. is submitting this Technical Report as part of a tenant improvement to expand the existing cleanroom. The existing cleanroom was built and completed by Cleanrooms West 1392 Industrial Drive Tustin CA 92780 (714) 258-7700 on June of 2017 (1020 ft' Clean Room and 100 ft2 Gown Room). The cleanroom expansion project is for an additional 279 ft' of space to the existing cleanroom. This report includes: Building/facility information Hazardous Materials Information Hazardous Materials Storage and Use Location Chemical Inventory Operational Controls/Information Hazardous Business Plan (HMBP) San Diego County Department of Environmental Health Approved Chemical Inventory from (CERS) California Environmental Reporting. Consolidated Emergency Response Contingency Plan (CERS) SDS Cryterion Medical Expansion Drawing (Cleanrooms West) Building/Facility & Company Information Cryterion Medical existing facility building located at 1949 Palomar Oaks Way, Suite 100, Carlsbad CA 92011 is Group "B" Occupancy and Fully Sprinklered. Building is divided into two suites by a demising wall. Cryterion Medical occupies suite 100 which (9,490 ft') square feet of the existing (19,105 ft2) square feet building. Cryterion Medical Inc. is a medical device company conducting business at 1949 Palomar Oaks Way, Suite 100 in the city of Carlsbad California. Hazardous Materials Information Cryterion Medical will store, use and handle Hazardous Materials at different locations Within the facility. Hazardous Materials are stored, used and handled in accordance with The 2016 California Fire Code (CFC). None of the Hazardous Materials stored, used or Handled exceed the maximum allowable Quantity per Control Area of Hazardous Materials posing a Physical Hazard. Hazardous Materials Storage and Use Area Locations Hazardous Materials will be stored, used and handled within the designated areas of Cryterion Medical as indicated below. All Hazardous Materials are stored, used and Handled in accordance with the 2016 California Fire Code. Table 1 (Designated Hazardous Materials Storage, Usage and Handling Area Locations) I nrtinn Mini or RflflM NAM Storage, Use or Handling Aron Tuna nf (c 1 R&D Use and Handling Nitrous Oxide 2 R&D Use and Handling Nitrous Oxide 3 Warehouse Storage Nitrous Oxide 4 Wetlab Use and Handling Nitrous Oxide 5 Cleanroom Use and Handling Nitrous Oxide 6 Warehouse Storage Nitrogen 7 Cleanroom Use and Handling Nitrogen CO I - - - - Elm H 1 liii IiiIL_I•I_Ij i::iL I::r1 i ml _.III .——• II •— _________ — •'1Iui IIc: 110 MEMNON WE II - •u L List of Hazardous Materials Stored, Used and Handled within Cryterion Medical Inc. Table 1.1 Reference Table for (Hazard Classifications and Class Codes listed in Table 1) HAZARD CLASSIFICATION HAZARDOUS CLASS CODE HAZARD CLASSIFICATION HAZARDOU S CLASS COMBUSTIBLE DUST CD FLAMMABLE SOLID FLS COMBUSTIBLE FIBER (LOOSE) CFL INERT GAS, GAS OR LIQUIFIED INERT GAS COMBUSTIBLE FIBER (BALED) CFB ORGANIC PEROXIDE LID, I THRU V OP-(UD THRU V) COMBUSTIBLE LIQUID CLASS II CL-11 OXIDIZER CLASS 1THRU 4 OX-(1 THRU 4) COMBUSTIBLE LIQUID CLASS lIlA CL-lIlA OXIDIZER GAS, GAS OR LIQUIFIED OX-GAS COMBUSTIBLE LIQUID CLASS IlIB CL-11113 PYROPHORIC MATERIAL PYRO CRYOGENIC FLAMMABLE CRYO-FLAM UNSTABLE (REACTIVE) 1 THRU 4 UR-(1 THRU 4) CONSUMER FIREWORKS lAG CFW1.4G WATER REACTIVE 1 THRU 3 WR-(1 THRU 3) CRYOGENIC OXIDIZING CRYO-OX CORROSIVES CORR CRYOGENIC INERT CRYO-INERT HIGHLY TOXICS HTOX EXPLOSIVES 1.1 thru 1.6 CORR TOXICS TOX FLAMMABLE GAS EXP-(1.1-1.6) IRRITANTS IRR FLAMMABLE LIQUID CLASS IA FIG OTHER HEALTH HAZARDS OHH FLAMMABLE LIQUID CLASS lB FL-IA SENSITIZERS SEN FLAMMABLE LIQUID CLASS IC FL-113 FLAMMABLE LIQUID CLASS COMBINATION (IA, 113 IC) FL-(IA,IBIC) Chemical Inventory I Manufacturer I Chemical Name Composition C.A.S. Percentage Description I Size I Inventory I Information Number Loctite Loctite AA3231 I Methyl Methacrylate 80-62-6 30-60 1 Light Cure Adhesive 25 ml 14 Methacrylic Acid 79-41-4 5-Jan 0.1-1 Butyl Hydroxytluene 128-37-0 5-Jan Cumene Hydroperoxide 80-15-9 0.1-1 Talc 14807-96-6 0.1-1 Cumene 98-82-8 Loctite Loctite S15056 Isobornyl Acrylate 5888-33-5 30-40 Light Cure Adhesive 6 N,N-Dimethylacrylate 2680-03-7 1-5 Loctite Loctite 3311 Acrylate Monomer Proprietary 30-60 Light Cure Adhesive I I Urethane Polymer Proprietary 30-60 1-5 Modified Acrylamide 2680-03-7 10-30 Photoinitiator 24650-42-8 1-5 Substituted Silane Proprietary 1-5 Photoinitiator Proprietary Loctite 4061 Ethyl 2-cyanoacrylate 7085-85-0 60-100 Light Cure Adhesive 20grams Thickener Proorietary 1-5 I Loctite I 4311 Ethyl 2-cyanoacrylate 7085-5 80-90 Light. Cure Adhesive I 28.3 grams I I 12 I I loz Kester Kester R275 TIN (Sn) 7440-31-5 85-100 Solder paste 35grams 2 Silver (Ag) 7440-22-4 1-3 1-3 Modified Rosin Trade Secret 1-3 Dicarboxylix Acid Trade Secret Kester Select-lO Isopropyl Alcohol 67-63-0 70-85 Soldering Flux 1 liter I 1 Phenoxyethanol 122-99-6 10-25 Modified Rosin Trade Secret ~5-:510 I Organic Acid I Trade Secret I -s I Dymax Dymax 203A-CTH- Adhesive 10 ml 1 F-VT Methyl Nonafluorobutyl 12 lb 3M Novec 7100 163702-07-6 20-80 Cleaning Agent 1 lb ether bottle Methyl 163702-08-7 20-80 Nonafluoroisobutvl Hydrox Isopropyl Rubbing Isoprophyl Alcohol 000067-63-0 50-75 70% Isopropyl Alcohol 1 gallon 7 gallon Alcohol Dow 251b Dow Corning Corning Medical Polydimethylsiloxane 63148-62-9 85-100 Medical Lubricant 1 lb Filuid . bottle Sunnyside Acetone Acetone 67-64-1 60-100 Solvent gallons 2.5 gallons Mobil Way Oil 2680-03-7 __________ _ Hydraulic Oil 1 gallon .5 gallon Mobil Spindle Oil Diterbutyl Phenol 128-39-2 0.1-<1 Lubrication Oil 1 gallon .75 gallon Distilllates 64742-47-8 80-90 Solvent 64741-89-5 10-20 Mobil Cutting Oil Fatty Acids,Tall Oil, Potassium Salt 61790-44-1 1-<5 Multi Purpose Oil 1 gallon .5 gallon __ Fatty Acids,Tall Oil, Reaction Products with 68440-25-5 1-<5 Ethanolamine Sodium Petroleum 68608-26-4 1-<5 Sulphonate ______ Scigrip I Acrylic glue Dichloromethane 75-09-2 50-70 Acrylic glue 1 Pint 1 Pint Ethyl Methyl Ketone 78-93-3 10-30 Methyl Acetate 79-20-9 1-10 Methyl Methacrylate 80-62-6 1-10 Scigrip I PVC Glue 2680-03-7 Tetrahydrofuran (THF) I I 109-99-9 45-70 Stabilized PVC glue 1 Pint 1 Pint Pre-Saturated 70% Alcohol-30 Dionized Texwipe Propan-2-ol 67-63-0 6.0 Wipes Water Wipes Enzol Enzymatic Subtilisins 9014-01-1 <5.0 Enzymatic Detergent 1 gallon 1 gallon Detergent Cidex OPA Cidex Ortho-Phthalaldehyde 643-79-8 Not Disinfectant 1 gallon 3 gallons determined Steris Germicidal IsopropylAlcohol 67-63-0 41.58 Germicidal 1 gallon 2 gallons 2-Butoxyethanol 111-76-2 <6.0 Ethylene Glycol 107-21-1 <1.0 Distilllates 64742-47-8 80-90 Solvent 64741-89-5 10-20 Mobil Cutting Oil Fatty Acids,Tall Oil, Potassium_Salt 61790-44-1 ______________ 1-<5 ____________ Multi Purpose Oil ___________________________ 1 gallon ____________ .5 gallon Fatty Acids,Tall Oil, Reaction Products with 68440-25-5 1-<5 Ethanolamine - Sodium Petroleum 68608-26-4 1-<5 Sulphonate Scigrip Acrylic glue Dichloromethane 75-09-2 50-70 Acrylic glue 1 Pint 1 Pint Ethyl Methyl Ketone 78-93-3 10-30 Methyl Acetate 79-20-9 1-10 Methyl Methacrylate 80-62-6 1-10 Scigrip PVC Glue 2680-03-7 PVC glue 1 Pint 1 Pint Christys PVC Glue Polyvinyl Chloride Resin Non-Haz PVC Glue 4 fl. Oz 4 fl. Oz Tetrahydrofuran (THF) Stabilized 109-99-9 45-70 5-20 Cyclohexanone 108-94-1 10-30 Methyl Ethyl Ketone 78-93-3 Relton Cutting Fluid Mineral Oil 64742-58-1 >70 Cutting Fluid 4 fl. Oz 4 f Oz Bland Additive Trade Secret <25 Bland Additive Trade Secret <16 Perfume -- -- <1.0 Green Dye, Pharmacy -- -- Trace Grade Texwipe Pre-Saturated Propan-2-ol 67-63-0 6.0 70% Alcohol-30 Dionized Wipes Water Wipes Enzol Enzymatic Subtilisins 9014-01-1 <5.0 Enzymatic Detergent 1 gallon 1 gallon Detergent Cidex OPA Cidex Ortho-Phthalaldehyde 643-79-8 Not determined Disinfectant 1 gallon 3 gallons Steris Germicidal Isopropyl Alcohol 67-63-0 41.58 Germicidal 1 gallon 1 2 gallons L 2-Butoxyethanol 111-76-2 <6.0 Ethylene Glycol 107-21-1 <1.0 Operational Controls The following operational controls are installed in Cryterion Medical Inc.'s facility located at 1949 Palomar Oaks Way, Suite 100 Carlsbad CA 92011. 1. Automatic Fire Extinguishing System for Buildings Cryterion Medical Inc.'s facility is equipped with approved, automatic wet fire extinguishing system in accordance with the 2016 California Fire Code. Fire Extinguishers Cryterion Medical Inc.'s facility is equipped with portable dry chemical fire extinguishers mounted not more that 75 feet apart within Cryterion Medical, Inc. facility located at 1949 Palomar Oaks Way, Suite 100 Carlsbad CA 92011 Seismic Bracing and Shelf Construction for Hazardous Materials Shelves greater than six feet high are braced and anchored and is of substantial construction. Shelves are provided with lips or guards. Shelf storage of Hazardous Materials are maintained in an orderly manner and in compliance with the code. Storage of Hazardous Materials The storage use and handling of Hazardous Materials in quantities not exceeding the maximum allowable quantityper control are in accordance with 2016 California Fire Code. None of the hazardous materials stored, used or handled at Cryterion Medical Inc.'s facility exceeds the maximum allowable quantity per control area for "B" Occupancy in accordance with 2016 California Fire Code. Approved Flammable Liquid and Hazardous Materials Storage Cabinets Flammable and combustible liquids stored in approved flammable and combustible liquid and approved (DOT) storage containers. Doors are well fitted, self-closing and equipped with a latch. Cabinets are in accordance with 2016 CFC. Safety cans are listed in accordance with (UL 30) when used to increased maximum allowable quantity of flammable or combustible liquids. All Hazardous Materials are stores in approved and/or (UL) listed self-closing safety cabinets or containers. Separation of Incompatible Materials Incompatible materials are separated from each other in storage in (FM) approved self-closing storage cabinets, or in separate (UL) listed or (DOT) approved waste collection containers. To ensure compliance one or more of the following methods will separate incompatible materials. Storage in separate approved self-closing storage cabinets as follows: Flammable/combustible liquids (Class I, II and Ill-A) is stored in approved flammable liquid cabinets. Acids are stored in Acid cabinets Bases are stored in Base cabinets. Trained personnel will further distinguish between incompatible materials (i.e. acids, bases; oxidizers and flammables) and store them in an appropriate manner with adequate distance to avoid incompatible reactions. Incompatible gases are separated by a distance of more than twenty feet. Incompatibles are separated using noncombustiblepartitions/barrier greater than 18" high. Employees whose job requires them to handle hazardous materials will receive chemical safety instruction on the separation of incompatible materials. 7. Empty containers and Tanks The storage of empty containers and tanks previously used for the storage of flammable or combustible liquids unless free form explosive vapors are stored as required for filled tanks and containers. Tanks and containers, when emptied will have the covers or plugs immediately replaced in openings. S. Sources of Ignition In locations where, flammable vapors could be present, precautions are taken to prevent ignition by eliminating or controlling sources of ignition. Adequate grounding and bonding are provided to prevent the accumulation of static electricity wherever Class I or II liquids are stored, used and handled. Smoking and open flames are prohibited in locations where flammable vapors could be present. Building Exhaust and Ventilation Exhaust and ventilation are provided to limit the risk of creating an emergency condition resulting from normal to abnormal operations. Means of exhaust/ventilation are provided with 50 cfm snorkel/exhaust system to pumped nitrous oxide at a rate of 0.25 cfm on four (4) minute cycles. Maximum use on one station would be approximately 80 cycles in eight (8) hour shift on a very busy day. Hazard Identification Signs Visible hazard identification signs are on stationary containers and above ground tanks and at entrances to locations where hazardous materials are stored, dispensed, used or handled, unless otherwise exempted by the fire code official. Laboratory use of Combustible and Flammable Liquids Cryterion Medical, Inc., will dispense combustible and flammable liquids. Combustible and flammable liquids when used in any amount in their pure form, will be used within the cleanroom and R&D area. Flammable liquid (70% isopropyl alcohol) will be used as a laboratory disinfectant. Combustible and/or flammable liquids transferred into Low-density polyethylene (LDPE) safety wash bottle(s) (Model No. 2425-0504) complying with OSHA regulations. Refer to (Figure 1) for picture of Low-density polyethylene (LOPE) safety wash bottles/squirt bottles (Model No. 2425-0504). Compressed Gases Storage, use and handling of compressed gas containers, cylinders, tank and systems shall comply with the 2016 CFC Chapter 53. Partially full compressed gas containers, cylinders or tanks containing residual gases shall be considered as full containers for the purposes of the controls required. Compressed gases in service and in storage are stored upright and adequately secured in a cylinder rack with one or more support straps and/or chains to prevent cylinders from falling or being knocked over. Cylinders, including empty ones, will have their caps in place and valves tightly closed. Cylinder will always be secured. Cylinders will only be moved by properly trained Cryterion Medical employees and Licensed Commercial Contractors with an approved cylinder cart and/or dolly. The storage, use and handling of compressed gases at Cryterion Medical, Inc., is in accordance with 2016 CFC. Oxidizing Materials Cryterion Medical, Inc., will store and use oxidizing materials in quantities below maximum allowable quantities indicated in the 2016 CFC. Oxidizing materials will be stored, used and handled in accordance with the 2016 CFC. Oxidizing Gases The storage, handling and use of oxidizing gases shall be in accordance with the 2016 CFC Chapter 50, Chapter 53, and Chapter 63. Cryterion Medical, Inc. installed a Nitrous Oxide Gas Exhaust System. The Nitrous Oxide Exhaust System(s) are designed to provide a continuous flow of Nitrous Oxide in and out of the system at an approximate rate of 0.25 cubic feet per minute (cfm). Treatment Systems Cryterion Medical will properly manage any hazardous waste generated at 1949 Palomar Oaks Way, Suite 100, Carlsbad CA 92011 in accordance with all Federal, State and Local regulations. ACT Enviro located at 2010 W. Mission Road, Escondido CA (760-489-5600) is contracted by Cryterion Medical to provide Hazardous Waste Disposal and Emergency Spill Clean Up. Employee Training and Response Procedures/Hazard Communication Employees responsible for the operational of areas in which hazardous materials are stored, dispensed, handled or used are trained initially and annually on the chemical hazards of the materials and the appropriate spill mitigation procedures. The supplied training is in accordance with the California Fire Code and CAL/OSHA. Cryterion Medical will provide Cal/OSHA compliant Hazard Communication safety training course and will continue to provide refresher courses every year. The following information is taught to each hazmat employee in the facility: In the event of a FIRE: First, immediately notify local fire department by dialing 911 from a landline when possible, versus a mobile phone. Next, if possible, have an employee trained on the proper use of a fire extinguisher extinguish the fire with an ABC or D fire extinguisher. If the fire cannot be extinguished safely with one extinguisher, evacuate all personnel from the building. SMALL SPILL: Use the emergency spill kits compatible with the spilled materials. Refer to Material Safety Data Sheets (MSDS) and/or Safety Data Sheets (SOS) for protective clothing and clean up guidelines. Waste products are handled and disposed of as hazardous waste. LARGE SPILL: Secure the area and warn others away. Contact Roel Cruz 760-206-7925 to develop a clean-up plan. Call the Fire Department by dialing 911 if the spill represents a health hazard or materials are released outside of the building. Arrangements are made with ACT Enviro for assistance with cleanup and disposal of any hazardous wastes. 17. Hazardous Materials Information Summary The chemical classifications within this technical report are based on 2016 CBC Tables 307.1(1) and 307.1(2) and the 2016 CFC Tables 5003.1.1(1) through 5003.1.1(4). None of the hazardous materials exceed the Maximum Allowable Quantities (MAQs) for Physical or Health Hazards for storage or use. This technical report identifies hazardous materials by chemical name and Chemical Abstract Service (CAS) Number. All classifications were based on hazard categories delineated in 2016 CFC Appendix E "Hazard Categories," chemical Material Safety Data Sheets (MSDS) and/or Safety Data Sheets (SOS). Aggregate quantities of each hazardous material and each hazard category have been specified. Materials have been identified as: in use, open system use, closed system use. The aggregate quantity in use and storage shall not exceed the quantity listed for storage. Cryterion Medical, Inc., will store, transport on site, use and handle hazardous materials in amounts not exceeding Maximum Allowable Quantities (MAQs) per Control Area listed in the 2016 California Fire Code Table 5003.1.1(1) through 5003.1.1(4) and the 2016 California Building Code Tables 307.1(1) and 307.1(2) in its facility located at 1949 Palomar Oaks Way, Suite 100, in the city of Carlsbad California. CRYTERION MEDICAL INC. NITROUS OXIDE AND NITROGEN LOCATIONS lom 11 -01 raZt EF-3 rROoF ROOF—\ OPENING. FRAMING AND FLASHING BY OTHERS) 0 lOxlO METAL DUCT WI PVC COATING-------BACKORAFT DAMPER 4"0 METAL PIPE W/ PVC COATING OR PVC PIPE CEILING\ Cj]) WET LA WET LAP 4"0 METAL PIPE W/ PVC COATING OR PVC PIPE EXH. NOZZLE 2" GAP BETWEEN NOZZLE AND HO SE 1- NOx HOSE TO EXHAUST PIPE HOSE TO EXHA EE(INSTALL I PIPE (INSTALL BY OTHERS) YOIHERS - NOx PUMP—/ NOx PUMP (FURNISH AND INSTALL (FURNISH AND INSTALL BY OTHERS) BY OTHERS) EXHAUST FAN -3 SECTION VIEW B • 1/4' 1-0' SAN DIEGO REGIONAL OFFICE USE ONLY MATERIALS 610HAZARDOUSflMLMlUO MMI PLAN CHECK#W2-O( f15P1JO '7f DcG' QUESTIONNAIRE DATE 11 I 2Ji'P oc Business Name Business Contact Telephone # Cryterion Medical, Inc. Roel Cruz (760) 960-3205 x Project Address (include suite) City State Zip Code APN# 1949 Palomar Oaks Way Suite 100 Carlsbad CA 92008- 213-091-01-00 Mailing Address (include suite) City State Zip Code Plan File# 1949 Palomar Oaks Way, Suite 100 Carlsbad CA 92008- CfC oi'— O' 12... Project Contact Applicant E-mail Telephone # Roel Cruz roel.cruz@bsci.com (760) 960-3205 x The following questions represent the facility's activities, NOT the specific project description. PART I! FIRE DEPARTMENT - HAZARDOUS MATERIALS OMSION: OCCUPANCY CLASSIFICATION: (not renulmd for nmilects within the Cliv of San dIcate by circling the item, whether your business Will use, process, or store any any or tne items are must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: "B" Facility's Square Footage (including proposed project): 18,943 SQFT 1. Explosive or Blasting r anic Peroxide 6 idizers Water Reactives 13. Corrosives 2. omEa~~ Cryogenics 14efHeaIthiiaa 3. 7. Pyrop orics 11. Highly Toxic or Toxic Materials 15. Noneor I nese. / 4. F a 8. Unstable Reactives 12. Radioactives ( . ,i questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 170, S Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: 2019-05-01 Expected Date of Occupancy: 2019-05-01 YES NO (for new construction or remodeling projects) 0 Z Is your business listed on the reverse side of this form? (check all that apply). 0 0 Will your business dispose of Hazardous Substances or Medical Waste in any amount? C9 0 Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? 0 Will your business store or handle carcinogens/reproductive toxins in any quantity? 0 Z Will your business use an existing or install an underground storage tank? 0 Will your business store or handle Regulated Substances (CalARP)? 0 Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 0 il Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). the answer to rany of the Diego, CA 92123. E] CalARP Exempt Date Initials El CalARP Required Date Initials o CalARP Complete Date Initials PART lii: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): The following questions are intenI - 2. ed to identify the mjQry of air pollution issues at the planning stage. Your project may require additional measures not identified by these questions. Some resintial projects may bë'ëJmpt from APCD requirements. If yes is answered for either questions 1, 2 or 5 or for more comprehensive requirements, please contt APCD at aocdcomo(5lsdcountv.ca.aov; (858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131. NO FEB 26 'J19 1. 0 Will the project disturb 100 square feet or more of existing building materials? 0 Will any load supporting structural members be removed? ASH: 0 (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by an individHkas passed an EPA-approved building inspector course? 0 lI (ANSWER ONLY IF QUESTION I or 2 IS YES) Based on the survey results, will the project disturb any-a rial? If es, a notification may be required at least 10 working days prior to commencing asbestos removal. Additionally, a notification may be require prio the removal of a load supporting structural member(s) regardless of the presence of asbestos. 0 ED Will the project or associated construction equipment emit air contaminants? See the reverse side of this form for typical equipment requiring an APCD permit. If yes, contact APCD prior to the issuance of a building permit. 0 0 (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school Briefly describe business activities: Briefly describe proposed project: I Medical Device Development - Tenant Improvements to existing I de p jleiuy that to the best of my knowledge and belief madeadeheare true and correct. 2.- / , r' - 19%3 7 Name of Owner or Authorized Aaent Sionatute o#Owner VAuthorized Aaent Date FOR USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:_____________________________________________________________________ BY: DATE: DCEMi*OtsRThER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY APCD cOuNTY-I11VID APCD COUNTY-HMD APCD (_ n ' ?d - *A stamNQt41p Pempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply HM-9171 (9/18) A County of San Diego - DEH - Hazardous Materials Division LIST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DIVISION Check all that apply: AUTOMOTIVE CHEMICAL HANDLING MISCELLANEOUS Battery Manufacturing/Recycling 0 Photographic Processing 0 Asphalt Plant Boat Yard 0 Pool Supplies/Maintenance 0 Biotechnology/Research Car Wash 0 Printing/Blue Printing 0 Cannabis-related Dealership Maintenance/Painting 0 Road Coatings 0 Manufacturing 0 Dispensary 0 Other 0 Machine Shop 0 Swimming Pool 0 Co-Generation Plant Painting 0 Toxic Gas Handler 0 Dental Clinic/Office 0 Radiator Shop 0 Toxic Gas Manufacturer 0 Dialysis Center 0 Rental Yard Equipment 0 Emergency Generator Repair/Preventive Maintenance METAL WORKING 0 Frozen Food Processing Facility Spray Booth 0 Anodizing 0 Hazardous Waste Hauler Transportation Services 0 Chemical Milling/Etching 0 Hospital/Convalescent Home Wrecking/Recycling 0 Finish-Coating/Painting 0 Laboratory/Biological Lab Flame Spraying 0 Medical Clinic/Office CHEMICAL HANDLING 0 Foundry 0 Nitrous Oxide (NO.) Control System C] Agricultural supplier/distributor 0 Machine Shop-Drilling/Lathes/Mills 0 Pharmaceuticals Chemical Manufacturer 0 Metal Plating 0 Public Utility El Chemical Supplier/Distributor 0 Metal Prepping/Chemical Coating 0 Refrigeration System 0 Coatings/Adhesive 0 Precious Metal Recovery 0 Rock Quarry Compressed Gas Supplier/Distributor 0 Sand Blasting/Grinding 0 Ship Repair/Construction C1 Dry Cleaning 0 Steel Fabricator 0 Telecommunications Cell Site 0 Fiberglass/Resin Application 0 Wrought Iron Manufacturing 0 Veterinary Clinic/Hospital Gas Station 0 Wood/Furniture Manufacturing/Refinishing O Industrial Laundry 0 Brewery/Winery/Distillery Laboratory El Laboratory Supplier/Distributor 0 OH and Fuel Bulk Supply AEROSPACE ELECTRONICS F-1 Pesticide Operator/Distributor 0 Aerospace Industry 0 Electronic Assembly/Sub-Assembly Aircraft Maintenance 0 Electronic Components Manufacturing El Aircraft Manufacturing 0 Printed Circuit Board Manufacturing NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMD) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880. UST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District. CHEMICAL 47—Organic Gas Sterilizers 32 -Acid Chemical Milling 33—Can & Coil Manufacturing 44—Evaporators, Dryers & Stills Processing Organic Materials 24— Dry Chemical Mixing & Detergent Spray Towers 35—Bulk Dry Chemicals Storage 55—Chrome Electroplating Tanks COATINGS & ORGANIC SOLVENTS 27 - Coating & Painting 37— Plasma Arc & Ceramic Deposition Spray Booths 38 - Paint, Stain & Ink Mfg 27 - Printing 27 - Polyester Resin/Fiberglass Operations METALS Metal Melting Devices Oil Quenching & Salt Baths 32 - Hot Dip Galvanizing 39—Precious Metals Refining ORGANIC COMPOUND MARKETING (GASOLINE. ETC) 25—Gasoline & Alcohol Bulk Plants & Terminals 25— Intermediate Refuelers 26—Gasoline & Alcohol Fuel Dispensing COMBUSTION 34—Piston Internal - Combustion Engines 13— Boilers & Heaters (1 million BTU/hr or larger) 14— Incinerators & Crematories 15— Burn Out Ovens 16— Core Ovens 20— Gas Turbines, and Turbine Test Cells & Stands 48— Landfill and/or Digester Gas Flares ROCK AND MINERAL Hot Asphalt Batch Plants Rock Drills Screening Operations 07—Sand Rock & Aggregate Plants 08— Concrete Batch, CTB, Concrete Mixers, Mixers & Silos 10— Brick Manufacturing OTHER 01 -Abrasive Blasting Equipment 03—Asphalt Roofing Kettles & Tankers 46— Reverse Osmosis Membrane Mfg 51 - Aqueous Waste Neutralization 11 - Tire Buffers 17— Brake Debonders 23— Bulk Grain & Dry Chemical Transfer & Storage 45— Rubber Mixers 21 -Waste Disposal & Reclamation Units 36—Grinding Booths & Rooms 40— Asphalt Pavement Heaters 43—Ceramic Slip Casting 41 - Perlite Processing 40— Cooling Towers - Registration Only 91 - Fumigation Operations 56— WNTP (1 million gal/day or larger) & Pump Station ELECTRONICS Automated Soldering 42— Electronic Component Mfg FOOD 12— Fish Canneries 12— Smoke Houses 50— Coffee Roasters 35— Bulk Flour & Powered Sugar Storage SOLVENT USE 28— Vapor & Cold Degreasing Solvent & Extract Driers 31 - Dry Cleaning NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITTING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600. HM-9171 (9/18) County of San Diego - DEH - Hazardous Materials Division c Carlsbad ity of Print Date: 12/23/2019 Permit No: PREV2019-0048 1949 Palomar Oaks Way, 100 BLDG-Permit Revision 2130910100 $ 0.00 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: St Dwelling Units: Bedrooms: Project Title Description: Work Class: Commercial Permit Revi5 Status: Closed - Finaled Lot #: pplied: 03/06/2019 Reference #: Issued: 04/15/2019 Construction Type Permit 12/23/2019 Finaled: Bathrooms: Inspector: Orig. Plan Check #: CBC2018-0612 Final Plan Check #: Inspection: CRYTERION MEDICAL: FLOOR PLAN CHANGE TO ALLOW UTILIZATION OF EXISTING ROLL UP DOOR AND MAXIMIZE THE EXPANSION SPACE Applicant: Owner: Contractor: ROEL CRUZ PALOMAR I LLC CLEAN ROOMS WEST INC• 1945 Palomar Oaks Way 1392 Industrial Dr 760-960-3205 CARLSBAD, CA 92011 Tustin, CA 92780-6416 714-258-7700 FEE AMOUNT BUILDING PLAN CHECK REVISION ADMIN FEE $35.00 MANUAL BUILDING PLAN CHECK FEE $112.50 Total Fees: $ 147.50 Total Payments To Date: $ 147.50 Balance Due: $0.00 Building Division 1635 Faraday Avenue, Carlsbad CA 92008-7314 1 760-602-2700 1 760-602-8560 f I www.carlsbadca.gov PLAN CHECK REVISION OR Development Services (7City of DEFERRED SUBMITTAL Building Division Carlsbad APPLICATION 1635 Faraday Avenue 760-602-2719 BI 5 www.carlsbadca.gov Original Plan Check NumberLC 7 021 - I Plan Revision Number 4E'1 tQ jdl .-0og8 General Scope of Revision/Deferred Submittal: CONTACT INFORMATION: Name _4t- Ct24/2- Phone .C15. Fax Address 14 46 999ft)*1t O' CA4.f 4144 041 City 9$4C6Av2 Zip Email Address FOEL. C1t417- A) Original plans prepared by an architect or engineer, revisions must be signed & stamped by that person. 1. Elements revised: Plans 0 Calculations 0 Soils 0 Energy 0 Other 2. 3. Describe revisions in detail List page(s) where each revision is shown Does this revision, in any way, alter the exterior of the project? Does this revision add ANY new floor area(s)? 0 Yes Does this revision affect any fire related issues? 0 Yes Is this a comp/ete set? Yes 0 No €5Signature ( O Yes )(N o 4No No 797, rnwol 11 Irit-fe-1 ;7 1635 Faraday Aven, Carlsbad, CA 92008 Eb: 760-602- 2719 f: 760-602-8558 Email: building@carlsbadca.gov www.cartcbadca.gov DATE: 3/18/2019 JURISDICTION: rc1ibad EsGil A SAFEbuUttompany UAAPL I CANT JURIS. PLAN CHECK #.: CBC2018-0612.rev SET:I 'a PROJECT ADDRESS: 1949 Palomar Oaks Way #100 PROJECT NAME: Cryterion Revision The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. LI The check list transmitted herewith is for your information. The plans are being held at EsGil until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. LI The applicant's copy of the check list has been sent to: EsGil staff did not advise the applicant that the plan check has been completed. EsGil staff did advise the applicant that the plan check has been completed. Person contacted: Date contacted: Mail Telephone (b) Fax 11nr'son Telephone #: Email: REMARKS: PREV20I9-0048 By: Jason Pasiut Enclosures: EsGil 3/11/2019 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576 [1997 UBC Plan Check Fee - Type of Review: r Complete Review r Repetitive Fee , FEI Repeats F p. Based on hourly rate r Other F Hourly EsGil Fee F Carlsbad CBC2018-06 12.rev 3/18/2019 [DO NOT PAY - THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK #.: CBC2018-0612.rev PREPARED BY: Jason Pasiut DATE: 3/18/2019 BUILDING ADDRESS: 1949 Palomar Oaks Way #100 BUILDING OCCUPANCY: B BUILDING PORTION AREA (Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) TI Revision hourly charge Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code #N/A 1997 UBC Building Permit Fee [] 1 j 1-2 . 50"\ 1 1 Structural Only 11Hr.@* L $90.00 $90.0O1 Comments: Sheet 1 of 1