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Home My WebLink About1959 Palomar Oaks Way; 200; PC2019-0040; PermitPrint Date: 07/22/2019 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1959 Palomar Oaks Way, 200 BLDG-Plan Check 2130922600 $14,418.10 Plan Check Permit Work Class: Commercial Lot#: Reference #: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Status: Applied: Issued: Permit Finaled: Inspector: Final Inspection: (cityof Carlsbad Permit No: PC2019-0040 Closed -Finaled 05/01/2019 05/29/2019 07/22/2019 Description: CCSD LLD: DEMISE SUITE 200 INTO TWO SUITES ( SUITE 200 CONSUMER ALLIANCE-8,879 SF AND SUITE 250 SPEC SUITE- 4,957 SF) Applicant: MARISSA CLOW FEE BUILDING INSPECTION FEE BUILDING PERMIT FEE ($2000+) Owner: CCSD LLC 1959 Palomar Oaks Way CARLSBAD, CA 92011 ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL MANUAL BUILDING PLAN CHECK FEE MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL SB1473 GREEN BUILDING STATE STANDARDS FEE Total Fees: $467.31 Tota I Payments To Date: Building Division $467.31 Contractor: SP WHITE CONSTRUCTION INC 2524 Gateway Rd Carlsbad, CA 92009-1742 760-931-1130 Balance Due: 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov AMOUNT $117.00 $1S9.31 $41.00 $110.00 $39.00 $1.00 $0.00 ( City of Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Check Est. Value PC Dep::~: ~~~~-5 __ -+1:,:,:z:,:CJ:~~~ Job Address __ i_'l_S'_,--'-Pt:M:.../4_on-,___,;;a.;...r--=0:;.;:;4'""t"'5--=u)a='J-1------Suite: __ ~_O_O __ APN: __ -<_f_3_o_'l_~_:t_~_OO ___ _ Tenant Name: U>YJS't.f"'1t.,,-.lt/Jia11ce_ CT/Project#: er N4 • Vo p 3 Y -----------=-----~'ff,, No• lottfr Lot#: A of 'I" fiJ1 11 Occupancy: __ /J ____ -_c,_Pi_,:;_·c_e... ___ Construction Type: V-B Fire Sprinklers: @/no Air Conditioning: {£) no BRIEF DESCRIPTION OF WORK: E)(SI-OCU4~1ed a.fl '1o(Jlr :51A;k .(be, fo Int ~Ar6::( ;..,~ /vJt> s~,vn,'<. S,.,,il<S SA.4;~ .la, """" :/SO. Cw,,,,'JtH" I. 1.e E"x~ fu... an-ess 11) JI'("~ gh-.f,1"". D Addition/New: ___________ New SF and Use, ___________ New SF and Use, ____ Deck SF, Patio Cover SF (not including flatwork) '¢ Tenant Improvement:) SF, Existing Use B-Ofe1c.-e Proposed Use f3.,, O~lC(. .Ji,/(:1".1t1.fo;> ~ 'i, flJSJ:C SF, Existing Use ______ Proposed Use ______ _ A-H!lit of Wb-,11: : 1 .310 .SF 0 Pool/Spa: ____ SF Additional Gas or Electrical Features? ------------- D Solar: ___ KW, __ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No D Plumbing/Mechanical/Electrical Only: --------------------------- D Other: -------------------------------------- APPLICANT (PRIMARY) Name: f5 oeS"I'.')"'-~/ ~n -&Sa. Clo...J Address: /C,,'zQ Ht:rk I Cltik fVo-rt,.._, -ti-330 City: ~"' Diejo State: Oil-Zip: q:uo f Phone: ('1/'t] aqte, -3SOo Email: ..,,r,ss'\ ~ Pnies,,,., "7-'· Cbvrl DESIGN PROFESSIONAL Name: _________________ _ Address: ________________ _ City: ________ State: ___ Zip: ___ _ Phone: ________________ _ Email: _________________ _ PROPERTY OWNER Name: S-tet,e. fAricL-t Address: f'1S&f fltl~ar <l:rts lJaJ -B--3 00 City: Cp.-/sboid State: CA Zip: 'f:/.o It Phone: {flf'I) f?G:::-3-0'115 Email: .:s~u,c.. @ let!,Jl"'1..,ta-. i"lc .co...,. CONTRACTOR BUSINESS Name: {A)n'ik Co.,~tn...fch·o..-. Address: :t~Q4 ~~~ Rei:,..J. City: Cartshc..d State: CA Zip: 1dooq Phone: (7<-o) 'f '31 -H Sa >' (oq Email: Jan--ivi@ ,ui,,;,e C°"sfn-ic~'lnc. co""""' QJ Architect State License: ___________ _ State License: Jo::21,KSb Bus. License: G'LN~ooo"13l -o~-~01· (Sec. 7031,5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 1 of 2 Email: Building@carlsbadca.gov Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: f hearby affirm under penalty of perjury~ of the folfowing declarations: □ I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. )l I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' COIJ).Pensation insurance carrier and policy number are: Insurance Com!any Name: ~ ~lf"lh:\S:".lk-'-"'"" /"J'S, Fi..~ Policy No. '1~'13o '3'1 -('i Expiration Date: <JI LOI / ~o ~o I □ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be come subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage Is unlawful, and shall subjett an employer to criminal penalties and civil fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for In section 3706 of the Labor Code, Interest and attorney's fees. CONTRACTOR SIGNATURE: --~~-· ----='---____ __,'x{AGENT DATE:_-'-"-l//_~_/_fl_ ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). □ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). □ I am exempt under Section ________ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone/ contractors' license number): S. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work): OWNER SIGNATURE: □AGENT DATE: _____ _ -------------------------- CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name: ____________________ Lender's Address: ___________________ _ ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration,,_f9rm or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes 121i,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 a school site? □ Yes )t No IF ANY OF THE ANSWERS ARE YES, A FINAL 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. APPLICANT CERTIFICATION: J certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative ofthe City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD 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 excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such pennit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT SIGNATURE: __.~,____-------~ ________ DATE: __ i//_:J.'1 __ /_/1 __ 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of2 Email: Building@carlsbadca.gov Rev. 06/18 ✓• EsG1I A SAFEbui!t Company DATE: May 9, 2019 JURISDICTION: Carlsbad □ APPLICANT □ JURIS. PLAN CHECK#.: -PC2019-0040 SET: I PROJECT ADDRESS: 1959 Palomar Oaks Way PROJECT NAME: Divide Suite 200 Into 2 Suites □ □ □ □ □ ~ □ □ 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. 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. EsGil staff did adviszehe plicant that the plan check has been completed. Person contacted: U') Telephone#: Date contacted: (b~) Email: Mail Telephone Fax In Person REMARKS: By: Kurt Culver EsGil 5/2/19 Enclosures: 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 Carlsbad CBPC2019-0040 May 9, 2019 [DO NOT PAY-THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PREPARED BY: Kurt Culver PLAN CHECK#.: CBPC2019-0040 DATE: May 9, 2019 BUILDING ADDRESS: 1959 Palomar Oaks Way BUILDING OCCUPANCY: BUILDING PORTION Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code cb AREA (Sq.Ft.) 310 --... ··-----·-··· ------·· 7 Buil . Per . F e 199 UBC dmg m1t e ... 1997 UBC Plan Check Fee • Valuation Multiplier 46.51 By Ordinance Type of Review: 0 Complete Review Reg. Mod. VALUE ($) 14 418 14.418 D Structural Only I D Repetitive Fee _-----..,. J Repeats D Other 0 Hourly EsGil Fee 1------IHr.@ • $96.951 Comments: Sheet 1 of 1 SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY RECORDID# __________________ 1 PLAN CHECK# ________________ _ BP DATE I I Business Name ~St.i~ A II 1C.tnCIL Business Contact ~ Uric)..... Telephone#( f'l'Q i'".3 _ CJ?IS Project Address Jt1S'f Po. State CA Zip Code 'I O I I APN# «I 30'f :{~<.::,OC) Mailing Address State Zip Code CA q~,, Plan File# Jct s<1 lo ,,., a I" Applicant E-mail ,-· Telephone,# .c~ l&t'1 he fol/owing questions represent the facil1 s activities, N t e specific project descnpfon. PART I: FIRE DEP RTMENT-HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: not r ulred t .!2!!s.Q}: Indicate by circling the item, whether your business will use, process, or store any of the Hawing hazardous mate a applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: Facility's Square Footage (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 4. Flammable Solids 8. Unstable Reactives 12. Radioactives PART II: SAN DIEGO COUNTY DEPAR ENT OF NVIRONMENTAL HEALTH -H ARDOUS MATERIALS DIVISION HMO: If the answer to any of the questions is yes, applicant must contact the aunty o an Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 11 , an Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: YOES NQ (for new construction or remodeling projects) 1. ~ Is your business listed on the reverse side of this form? (check all that apply). 2. □0 '18 Will your business dispose of Hazardous Substances or Medical Waste in any amount? 3. M Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 4. 5. 6. 7. 8. □ □ □ □ □ pounds and/or 200 cubic feet? I Will your business store or handle carcinogens/reproductive toxins in any quantity? Will your business use an existing or install an underground storage tank? Will your business store or handle Regulated Substances (Ca/ARP)? Will your business use or install a Hazardous Waste Tank System (Title 22, Article 1 0)? Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or realer than 1,320 a/Ions? California's Above round Petroleum Stora e Act . □ CalARP Exempt I Date Initials 0 Ca/ARP Required J Date Initials 0 Ca/ARP Complete J Date Initials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCO): Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San Diego, CA 92131 apcdcomp@sdcounty.ca.gov (858) 586-2650). [*No stamp required if 01 Yes and 03 Yes and 04-06 No]. The following questions are intended to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified by these questions. For comprehensive requirements contact APCD. Residences are typically exempt, except -those with more than one building• on the property; single buildings with more than four dwelling units; townhomes; condos; mixed-commercial use; deliberate burns; residences forming part of a larger project. ['Excludes garages & small outbuildings.] iii Will the project disturb 160 square feet or more of existing building materials? Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition. (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? 4. 5. 6. □ □ □ (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification may be required 10 working days prior to commencing asbestos removal. Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD permit. 0 (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school bounda Briefly describe business activities: Briefly describe proposed project: _,_ _ • · ,fef\Ot'\r-~-r -~, ~I 2 3...,;~~ o,,,..s:;( Offi -CJ,fd; .,_ GP-t"'7.Jd, . se.--vic.c , C.,,,...'r;I w-t-o s tr:,t'f I d~.f!are I.Vlder penal!,ypf perjury that the best of my knowledge and belief t sponies m~ )lerein are true and correct. _;,_rr.:....:..:.:,a:..::..n..;...& ... sa.-..._::~:::.>,.>c.=::..½,J=--------~ 4 I ;tq I t-=t Name of Owner or Authorized Agent Signature of Owner or Authorized Agent Date FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: _______________________________ _ BY· DATE· I I EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMD* APCD COUNTY-HMD APCD COUNTY-HMO APCD *A stamp m this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply. HM-9171 (08/15) 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 0 Battery Manufacturing/Recycling 0 Boat Yard 0 Car Wash D Dealership Maintenance/Painting D Machine Shop D Painting D Radiator Shop D Rental Yard Equipment D Repair/Preventive Maintenance D Spray Booth D Transportation Services D Wrecking/Recycling CHEMICAL HANDLING D Agricultural supplier/distributor D Chemical Manufacturer D Chemical Supplier/Distributor D Coatings/Adhesive D Compressed Gas Supplier/Distributor D Dry Cleaning 0 Fiberglass/Resin Application D Gas Station D Industrial Laundry D Laboratory D Laboratory Supplier/Distributor □ Oil and Fuel Bulk Supply D Pesticide Operator/Distributor CHEMICAL HANDLING 0 Photographic Processing D Pool Supplies/Maintenance 0 Printing/Blue Printing D Road Coatings D Swimming Pool D Toxic Gas Handler D Toxic Gas Manufaclurer METAL WORKING □Anodizing D Chemical Milling/Etching D Finish-Coating/Painting D Flame Spraying D Foundry D Machine Shop-Drilling/Lathes/Mills D Metal Plating D Metal Prepping/Chemical Coating D Precious Metal Recovery D Sand Blasting/Grinding D Steel Fabricator D Wrought Iron Manufacturing AEROSPACE D Aerospace Industry D Aircraft Maintenance D Aircraft Manufacluring OTHERS AND MISCELLANEOUS D Asphalt Plant D Biotechnology/Research D Chiropractic Office D Co-Generation Plant D Dental Clinic/Office 0 Dialysis Center D Emergency Generator D Frozen Food Processing Facility D Hazardous Waste Hauler D Hospital/Convalescent Home D Laboratory/Biological Lab D Medical Clinic/Office D Nitrous Oxide (NO.) Control System D Pharmaceuticals 0 Public Utility 0 Refrigeration System D Rock Quarry D Ship Repair/Construction D Telecommunications Cell Site D Veterinary Clinic/Hospital D Wood/Furniture Manufacturing/Refinishing ELECTRONICS D Electronic Assembly/Sub-Assembly D Electronic Components Manufacturing 0 Printed Circuit Board Manufacturing NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, ANO DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS UST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880. LIST 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 18-Metal Melting Devices 19-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 ELECTRONICS 29 -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 30 -Solvent & Extract Driers 31 -Dry Cleaning ROCK AND MINERAL 04 -Hot Asphalt Batch Plants 05 -Rock Drills 06 -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 Oebonders 23 -Bulk Grain & Ory Chemical Transfer & Storage 45 -Rubber Mixers 21 -Waste Disposal & Reclamation Units 36 -Grinding Booths & Rooms 40 -Asphalt Pavement Healers 43 -Ceramic Slip Casting 41 -Perlite Processing 40 -Cooling Towers -Registration Only 91 -Fumigation Operations 56 -WWTP (1 million gal/day or larger) & Pump Station 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 (08/15) County of San Diego -DEH -Hazardous Materials Division C cicyof Carlsbad PURPOSE CLIMATE ACTION PLAN CONSISTENCY CHECKLIST 8-50 Development Services Building Division 1635 Faraday Avenue (760) 602-2719 www.carlsbadca.gov This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance requirements apply to their projects. Unless none of the requirements apply, the completed checklist must be included in the building permit application. It may be necessary to supplement the completed checklist with supporting materials, calculations oi;,,-certifications, to demonstrate full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach to comply with energy- related measures will need to attach to this checklist separate calculations and documentation as specified by the ordinances . ...i1 If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance, an explanation must be provided to the satisfaction of the Building Official. ...i1 Details on CAP ordinance requirements are available on the city's website. Property Address/APN: Applicant Name/Co.: Applicant Address: Contact Phone: Contact Email: Contact information of person completing this checklist (if different than above): Name: Company name/address: B-50 Contact Phone: Contact Email: Applicant Signature: "f'~ &_.r Page 1 of 3 ' \l),,av-is~a.@ ~~'S"''.J ..--e· c oVh Date: _'5_/_1 L-/_I ? __ _ Revised 04/19 City of Carlsbad Climate Action Plan Consistency Checklist .. -. \ Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project. For residential alterations and additions to existing buildings, contact the building counter for the building permit valuation. Building Permit Valuation (BPV) $ ___________ _ New construction 1A □ Alterations: □ exempt □ BPV ~ $60,000 1A 1-2 family dwellings and townhouses with attached garages □ Electrical service panel upgrade 1A only Multi-family dwellings only where interior finishes are removed □ BPV ~ $200,000 1A and significant,§jte work and upgrades to structural and ' mechanical, electrical, and/or plumbing systems are proposed ,E Nonresidential □ New construction 1B and 2 ):( Alterations 2 ... 1. Electric Vehicle Charging A. D Residential New construction and major alterations (or electric panel upgrade)* Please refer to Carlsbad Ordinance CS-349 when completing this section. □ One and two-family residential dwelling or townhouse with attached garage: □ One EVSE ready parking space required □Exception : □ Multi-family residential· □ Exception · Total Parking Spaces EVSE Soaces Proposed Caoable I Ready Installed I Calculations: Total EVSE spaces = .10 x Total parking (rounded up to nearest whole number) EVSE Installed = Total EVSE Spaces x .50 (rounded up to nearest whole number) EVSE other-Total EVSE spaces -EVSE Installed (EVSE other may be "Capable," "Ready" or "Installed.") I Total I I *Major alterations are: (1) for one and two-family dwellings and townhouses with attached garages, alterations have a building permit valuation<! $60,000 or include an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit valuation ~ $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed. B D Nonresidential new construction (includes hotels/motels) □ Exception · Total Parking Spaces EVSE Spaces Proposed Capable I Ready l Installed I Total I I I Calculation· Refer to the table below· Total Number of Parking Spaces provided Number of reauired EV Spaces Number of reauired EVSE Installed Spaces D 0-9 1 1 D 10-25 2 1 D 26-50 4 2 D 51-75 6 3 D 76-100 9 5 D 101-150 12 6 D 151-200 17 9 D 201 and over 10 percent of total 50 percent of Required EV Soaces Updated 4/12/20 19 2 City1of Carlsbad Climate Action Plan Consistency Checklist . ~ 2. D Transportation Demand Management (TDM) A. List each proposed nonresidential use and gross floor area (GFA) allocated to each use. B. Employee ADT/1,000 square feet is selected from the table below. Employee ADT for first 1,000S.F. :lo ~o Employee ADT for each subsequent 1,000 S.F. ;20 ~o If total employee ADT is greater than or equal to 110 employee ADT, a TOM plan is required. TOM plan required: Ye~ No □ - - Updated 4/12/2019 Employee ADT Estimation for Various Commercial Uses ADT for first 1,000 s.f. EmpADTI 1000s.f.1 Restaurant 11 Retaib 8 Industrial 4 Manufacturing 4 Warehousin 4 1 Unless otherwise noted, rates estimated from /TE Trip Generation Manual, 10'hEdition 11 4.5 3.5 3 1 2 For all office uses, use SAN DAG rate of 20 ADT/1,000 sf to calculate employee ADT 3 Retail uses include shopping center, variety store, supermarket, gyms, pharmacy, etc. Other commercial uses may be subject to special consideration Sample calculations: Office: 20,450 sf 1. 20,450 sf/ 1000 x 20 = 409 Employee ADT Retail: 9,334 sf 1. First 1,000 sf= 8 ADT 2. 9,334 sf -1,000 sf = 8,334 sf 3. 8,334 sf/ 1,000 x 4.5 + 8 = 46 Em lo ee ADT ~---- $t /1000 'Sr;, c1cm X 20 :: X 1..0 - Total Employee ADT 3 ;r, ' { ;., '. }! H.M. Pitt Labs, Inc. Lab Number: 168089-235026 / .... 9590 Chesapeake Dr · Ste 5 · San Diego, CA 92123 Tel: 619-474-8548 · Fax: 858-412-3305 __ , Company: White Construction, Inc. 2524 Gateway Rd Carlsbad, CA 92009 D r:-·-·-~-"V,_ D ~ .,J' re--( ', ~ ...... i t: • I\ . -~• ",,.,;, ;, . .,_,. i ft MAY O I 2019 c,. CY ,·r C,\1~(LSBAD E3UiL.lJi;,K; DIVISION Job Site: 1959 Palomar Oaks Way, Carlsbad CA-Suite 200 Lab Notes: 48 HR TAT Date Entered: Analyzed By: Date Analyzed: Customer PO / Claim#: Contract Number: Date Sampled 04/03/2019 04/03/2019 Tisha Melville 04/04/19 NA Who Sampled Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT -EPA-600/R-93/116 AND EPA-600/M4-82-020 Analysis Number: 168089-1 Customer Number: 01 Class/ff cation: 2X2 Certlng Tile O.scrlption: White Room 1 Results: Non-Asbestos: 60% Cellulose Fibers & 10% Glass Fibers In Gray Ceiling TIie Analysis Number: 168089-2 Customer Number: 02 Classification: 2X2 Celling Tile Description: White Room 2 Results: Non-Asbestos: 70% Cellulose Fibers & 5% Glass Fibers in Gray Ceiling Tile Analysis Number: 168089-3 Customer Number. 03 Classification: 2X2 Ceiling Tile Description: Whtte Room 3 Results: Non-Asbestos: 70% Cellulose Fibers & 5% Glass Fibers in Gray Celllng Tile Analysis Number: 168089-4 Customer Number: 04 Classification: 2X2 Ceiling TIie Descrlptlon: White Room 4 Results: Non-Asbestos: 60% Cellulose Fibers & 10% Glass Fibers In Gray Ceiling TIie -All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the infonnation submitted with the samples unless done by an employee of H.M. PITT lABS. INC. · These test results relate only to the sample(s) identified above. · This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government. This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc. Samples are archived for 90 days from date of receipt and will be disposed of property following this period. · Quantitative value Is based on PLM CVES (Calibrated Visual Estimates} with a detection limit of <1 %. APPRDVEDBY:_~_~ __ .s._. _Q<-('_· _ DllBd: 04/W2D■ REIDEIBY:4't~s.~ LELAND S. PITT, CIH LHPltl Page 1 of9 H.M. Pitt Labs, Inc. Lab Number: 168089-235026 9590 Chesapeake Dr -Ste 5 -San Diego, CA 92123 Tel: 619--474-8548 -Fax: 858-412-3305 Company: Job Site: White Construction, Inc. 2524 Gateway Rd Carlsbad, CA 92009 1959 Palomar Oaks Way, Carlsbad CA -Suite 200 Lab Notes: 48 HR TAT Date Entered: Analvzed By: Date Analyzed: Customer PO / Claim#: Contract Number. Date Sampled 04/03/2019 04/03/2019 Tisha Melville 04/04/19 NA Who Sampled Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT -EPA-800/R-93/116 AND EPA-600/M-4-82-020 Analysis Number: Customer Number: Classfficatlon: 168089-5 05 2X2 Ceiling Tile Description: White Room 5 Results: Non-Asbestos: 70% Cellulose Fibers & 5% Glass Fibers in Gray Ceiling Tile Analyst. Number: 168089-8 Customer Number: 06 Claulticatlon: 2X2 Celling Tile Description: White Room 6 Results: Non-Asbestos: 70% Cellulose FiberS & 3% Glass Fibers in Gray Celling Tile Analysis Number. 168089-7 Customer Number. 07 Classification: 2X2 Ceiling TIie Description: White Room 7 Results: Non-Asbestos: 80% Cellulose Fibers In Gray Ceiling THe Analysis Number: 168089-8 Cu5tomer Number: 08 ClusJlfcation: Drywall Description: White Room 1 Results: Non-Asbestos: Non-Fibrous White Drywall · All samples tested aa submitted to the lab. H.M. PITT LABS, INC. does not assume responslblllty for the accuracy of the information submitted With the samples unless done by an employee of H.M. PITT LABS, INC. These test results relate only to the sample(s) identified above. This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government. -This report shaN not be reproduced, except In full, wlthOut written approval of H.M. Pitt Labs, Inc. · Samples are archived for 90 days from date of receipt and will be disposed cl properly following thiS period. • Quantitative value Is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1 %. APPRIVflBY:_~-~-<'eM-J'_s_G:J(_· _ Datad: M/M/2n LeL.AND S.PITT,CIH LNPllt Page 2of9 m•;r,-. ' { ~ H.M. Pitt Labs, Inc. Lab Number: 168089-235026 '• {.• I' 9590 Chesapeake Dr · Ste 5 -San Diego, CA 92123 Tel: 619-474-8548 · Fax: 858-412-3305 ·-· Company: White Construction, Inc. 2524 Gateway Rd Carlsbad, CA 92009 Job Site: 1959 Palomar Oaks Way, Carlsbad CA-Suite 200 Lab Notes: 40 HR TAT Data Entered: Analyzed By: Date Analyzed: Customer PO / Claim#: Contract Number: Date Sampled 04/03/2019 04/03/2019 Tisha Melville 04/04/19 NA Who Sampled Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT-EPA-600/R-93/116 AND EPA-600/M4-82-020 Anatys;s Number: 168089-9 Customer Number: 09 Classification: Drywall Description; White Room 2 Ruutts: Non-Asbestos: Non-Fibrous White Drywall Analysis Number: 168089-10 Customer Number: 1 o C/asslfkatlon: Drywall Description: While Room 3 Results: Non-Asbestos: Non-Fibrous White Drywall Analysis Number: 168089-11 Customer Number. 11 Classfflclltlon: Drywall Description: White Room 4 Results: Non-Asbestos: Non-Fibrous White Drywall Analysis Number: 168089-12 Customer Number: 12 Classltlcatlon: Drywall DHcrlptlon: White Room 5 Results: Non-Asbestos: Non-Fibrous White Drywall · All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information submitted with the samples unless done by an employee of H.M. PITT LABS, INC. · These test results relate only to the sample(s) Identified above. · This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government. · This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, lnc. · Samples are archived for 90 days from date of receipt and will be disposed of properly following this period. · Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection llmlt of <1%. APPRIIVEDBY:_d/4_~_c.P_s_~---Dat8d: 04/14/21■ LELAND S. PITT, CIH Lee Pitt Page 3of9 { ~~ @:,; \ H.M. Pitt Labs, Inc. Lab Number: 168089-235026 •. (.• /' 9590 Chesapeake Dr · Ste 5 · San Diego, CA 92123 Tel: 619-474-8548 • Fax: 858-412-3305 .!U:f.- Company: Date Entered: 04/03/2019 White Construction, Inc. Analyzed By: Tisha MeMlle 2524 Gateway Rd Date Analyzed: 04/04/19 Carlsbad.CA 92009 Customer PO / Clalm#: NA Contract Number: Job Sita: 1959 Palomar Oaks Way, Carlsbad CA -Suite 200 Date §!m~d WhoSamglgd 48 HR TAT 04/03/2019 Louis Luick Lab Notes: POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT-EPA-600/R-93/116 AND EPA-600/M4-82-020 Analysis Number: 188089-13 Customer Number: 13 Classification; Results: Analysis Number. Customer Number: Classification: Drywall Non-Asbestos: Non-Fibrous White Drywall 18808944 14 Orywal Results: Non-Asbestos: Non-Fibrous White Drywall Analysis Numb.,.: 188089-15 Customer Number: 15 ClassiRcatlon: Joint Compound Results: Non-Asbestos: Non-Fibrous White Joint Compound Analysis Number: 188089-16 Cutltomer Numb.-: 16 Classlflcatlon: Joint Compound Results: Non-Asbestos: Non-Fibrous White Joint Compound Description: White lwom 6 Description: White Room 7 Description: White Room 1 Description: White Room 2 · All samples tested as submitted to the lab. H.M PITT LABS, INC. does not assume responsibility for the accuracy of the Information submitted with the samples unless done by an employee of H.M. PITT LABS, INC. · These test resulls relate only to the sample(s) identified above. · This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government. · This report shall not be reproduced, except In fl.IN, without written approval of H.M. Pitt Labs, Inc. · Samples are archived for 90 days from date of receipt and will be disposed of properly following this period. • Quantitative value Is based on PLM CVES (Callbrated Visual Estimates) with a detection limit of <1%- APPRDVBIIY:_~-~-~ __ s_. _o,,_· _ Datllll: 14/ll/2DII LELAND S. PITT,CIH LHPltt Pege4 of9 (/1:\_._,"/1 __ :· H.M. Pitt Labs, Inc. Lab Number: 168089-235026 ~ 9590 Chesapeake Dr· Ste 5 · San Diego, CA 92123 Tel: 619-474-8548 · Fax: 858-412-3305 Company: Date Entered: 04/03/2019 White Construction, Inc. Analyzed By: Tisha Melville 2524 Gateway Rd Date Analyzed: 04/04/19 Carlsbad, CA 92009 Customer PO / Claim#: NA Contract Number: Job Site: 1959 Palomar Oaks Way, Carlsbad CA -Suite 200 Date Sami;i1ed Who SamQled Lab Notes: 48 HR TAT 04/03/2019 Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT· EPA-600/R-93/116 AND EPA-600/M4-82-020 Analysis Number: 168089-17 Customer Number: 17 Classification: Joint Compound Description: White Room 3 Results: Non-Asbestos: Non-Fibrous White Joint Compound Analysis Number: 168089-18 Customer Number: 18 Classification: Joint Compound Description: White Room 4 Results: Non-Asbestos: Non-Fibrous White Joint Compound Analysis Number: 168089-19 Customer Number: 19 Classlflciltlon: Joint Compound Description: White Room 5 Results: Non-Asbestos: Non-Fibrous White Joint Compound Analysis Number: 168089-20 Customer Number: 20 Classllkatlon: Joint Compound De:scrlptfon: White Room 6 Results: Non-Asbestos: Non-Fibrous White Joint Compound · All samples tested as submltted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the Information submitted with the samples unless done by an employee of H.M. PITT LABS, INC. · These test results relate only to the sample(s) identified above. This report may not be used to dalm endorsement by NVLAP or any agency of the Federal Government. This report shall not be reproduced, except In full, without wrltten approval of H.M. Pitt Labs, Inc. Samples are archived for 90 days from date of recelpt and will be disposed of properly following this period. · Quantitative value Is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%. APPRnmBY:_Jz{/4_C&No_J'_s._. Qc( __ _ llatlt 04/14/2011 RIVIWEDBY:~~s.G.?.,t Ll!!LAND I, PITT, CIH Leef'ltt Page 5of9 Lab Number: 168089-235026 Tel: 619-474-8548 · Fax: 858-412-3305 Company: White Construction, Inc. 2524 Gateway Rd Carlsbad.CA 92009 Job Site: 1959 Palomar Oaks Way, Carlsbad CA -Suite 200 L;lb Notes: 48 HR TAT Date Entered: Analyzed By: Date Analyzed: Customer PO / Claim#: Contract Number: Date Sampled 04/03/2019 04/03/2019 Tisha Melville 04/04/19 NA Who Sampled Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT-EPA-600/R-93/116 AND EPA-600/M4-82-020 An•lysls Number: 168088-21 Customer Number: 21 Cl•ssificatlon: Joint Compound Description: White Room 7 Results: Non-Asbestos: Non-Fibrous White Joint Compound Analysis Number: 188089--22 Customer Number: 22 ClalUlificatlon: Cove bese mastic Dacrlpffon: White Outside Room 3 Results: Non-Asbestos: Non-Fibrous Yellow Cove Base Mastic Analysis Number: 168089·23 Customer Number: 23 Claalflcatlon; Cove base mastic Description: White Room 4 Results: Non-Asbestos: Non-Fibrous Yellow Cove Base Mastic Analysis Number: 168089-24 Customer Number: 24 Claaltieatlon: Cove base mastic Description: White Outside Room 5 Retsults: Non-Asbestos: Non-Fibrous While Cove Base Mastk: · All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility b-lhe accuracy of the lnfOrmatlon submitted with the samples unless done by an employee of H.M. PITT LABS, INC. • These test resuHs relate only to the sample(s) Identified above. · This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government · This report shall not be reproduced, except in full, Without written approval of H.M. P"rtt Labs, Inc. · Samples are archived fOr 90 days from date of receipt and will be disposed of properly following this period. Quantitative value is based on PLM CVES (Calrbrated visual Estimates) with a detection &mit of <1%. APPRIVEIBY:_t£._~_J'_. _s._._~_.., __ arllt 11/14/DII LtLAN'D s. PITT, CIH LNPffl Page 6of9 H.M. Pitt Labs, Inc. Lab Number: 168089-235026 9590 Chesapeake Dr· Ste 5 · San Diego, CA 92123 Tel: 619-474-8548 · Fax: 858-412-3305 Company: White Construction, Inc. 2524 Gateway Rd Carlsbad, CA 92009 Job Site: 1959 Palomar Oaks Way, Carlsbad CA -Suite 200 Lab Notes: 48 HR TAT Date Entered: Analyzed By: Date Analyzed: Customer PO / Cfalm#: Contract Number: Date Sampled 04/03/2019 04/03/2019 Tisha Melville 04/04/19 NA Who Sampled Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT-EPA-600/R-93/116 AND EPA-600/M4-82-020 Analysis Number: 168089-25 Customer Number: 25 Classification: Cove base mastic Description: White Room 7 Results; Non-Asbestos: Non-Fibrous Yellow Cove Base Mastic Analysls Number: 188089-26 Customer Number: 26 Classification: Carpet Glue Description; Yellow Room 4 Results: Non-Asbestos: 3% Synthetic Fibers in Yellow Glue Analysis Number: 168089-27 Customer Number; 27 Classlflcat/on: Carpet Glue Description: Yellow Outside Room 5 Results: Non-Asbestos:< 1% Synthetic Fibers in Yellow Glue Analy11ls Number: 168089-28 Customer Number: 28 Classlflcation: Carpet Glue Description: Yellow Room 7 Results: Non-Asbestos: 10% Cellulose Fibers in Yellow Glue · All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information submitted with the samples unless done by an employee of H.M. PITT LABS, INC. · These test results relate only to the sample(s) identified above. · This report may not be used to claim endOtSement by NVLAP or any agency of the Federal Government. · This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc. · Samples are archived for 90 days from date of receipt and will be disposed of properly following this period. · Quantttative value Is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%. APPRDVmBY:_~_~_J'_s_. -~-· -Dated: 14/04/2018 IIEVIWEDBY:&~s~ I.ELAND S. PITT, CIH Lee Pitt Page 7of9 { ,·, m-'\ i~ !J H.M. Pitt Labs, Inc. Lab Number: 168089-235026 ; 9590 Chesapeake Dr· Ste 5 · San Diego, CA 92123 Tel: 619-474-8548 · Fax: 858-412-3305 ·-· Company: White Construction. Inc. 2524 Gateway Rd Carlsbad, CA 92009 Date Entered: Anafyzed By: Date Analyzed: Custom• PO / Clalm#: Contract Number: 04/03/2019 Tisha Melville 04/04/19 NA Job Site: 1959 Palomar Oaks Way, Carlsbad CA -Suite 200 Date Sampled 04/03/2019 Who Sampled Louis Luick Lab Notes: 48 HR TAT POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT-EPA-600/R-93/116 AND EPA-600/M4-82-020 Analysis Number: 16808!J.29 Customer Number: 29 Class/fft:atlon: Floor tile 12 In lt 12 in De#rlpt/on: While Break Room Results: Non-Asbestos: Non-Fibrous White Floor Tile Analysis Number: 168089-30 Customer Number: 30 Classlflt:atlon: Floor lile 12 In x 12 in Description: White Break Room Results: Non-Asbestos: Non-Fibrous White Floor Tile Analysis Number: 168089-31 Customer Number: 31 Clas/tlcation: Floor tile 12 in x 12 In Description: White Break Room Results: Non-Asbestos: Non-Fibrous White Floor TIie Analysis Number: 118089-32 Customer Number: 32 Claslflcatlon: MasUcs and Glues Description: Brown Break Room Results: Non-Asbestos: 10% Cellulose Fibers in Yellow Glue · All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not asS(Jme responsibJIHy for the accuracy of the information submitted with the samples unless done by an employee of H.M. PITT LABS, INC. • These test results relate only to the sample(s) identified above. · This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government. · This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc. · Samples are archived for 90 days from date of receipt and will be disposed of properly following this period. · Quantitative value is based on PLM eves (Calibrated Vrsual Estimates) with a detection llmit of <1%. APPROVmBY:_~_;i_· ~_J'_s_. ~-~ --DalBd: 14/114/2111 LEJ.AND S. PITT, CIH .... Pitt Page 8of9 @•:..- ' ( ~: '· ·-· i' Company: H.M. Pitt Labs, Inc. 9590 Chesapeake Dr· Ste 5 · San Diego, CA 92123 White Construction, Inc. 2524 Gateway Rd Carlsbad, CA 92009 Job Site: 1959 Palomar Oaks Way, Carlsbad CA~ Suite 200 Lab Notes: 48 HR TAT Lab Number: 168089-235026 Tel: 619-474-8548 · Fax: 858-412-3305 Date Entered: Analyzed By: Date Analyzed: Customer PO / Claim#: Contract Number: Date Sampled 04/03/2019 04/03/2019 Tisha Melville 04/04/19 NA Who Sampled Louis Luick POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT-EPA-600/R-93/116 AND EPA-600/M4-82-020 Analysts Number: 168089-33 Customer Number: 33 Classification: Mastics and Glues Description: Brown Break Room Results: Non-Asbestos: 10% Cellulose Fibers in Yellow Glue Analysis Numw: 168089-34 Customer Number: 34 Classification: Mastics and Glues Descrlptlon: Brown Break Room Results: Non-Asbestos: 15% Cellulose Fibers In Yellow Glue · AU samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responslbillty for the accuracy of the information submitted with the samples unless done by an employee of H.M. PITT LABS, 1NC. · These test results relate only to the sample(s) identlfted above. · This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government. This report shall not be reproduced. except in full, without written approval of H.M. Pitt Labs, Inc. Samples are archived for 90 days from date of receipt and will be disposed of properly following this period. Quantitative value is based on PLM CVES (Calibrated Visual Estimates)with a detection limit of <1%. APfRDVED BY:_~-~-~_cf_s_. c::J{ ___ Datld: 14/04/28111 llfVDEDBY:,f;/~s.~ LELAND S. PITT, CIH Lee Pitt Page 9of9 • H.M. Fll''I LABS, INL. Asbestos Survey Chain .of Custody 9590 Chesapeake Drive, Suite 5 San Diego, CA 92123 "°': ~l(1, . . (619)474-8548 Fax:(858)412-3305 Lab ID#: \\,\I)\~ CUSTOMER INFORMATION PR~:r :l~oiliiATION ANN-, SIS"REQUESTED BIIITo:La\.'.jk_ ~ .... ~ .. cJ,.,...._ Bainpled BY;/.u.,-7 1-H ... q~~ 1·1t :a ---WW~ -I ACM Type ~-,.. on ■ Address:7"') ~_J/ d Location: /'is-, • ';/!. I; t£°JLL 11-lt-t JILL~fi.A,r "'l(.. ~ WILi/' ~ F,, .;--I -Ul._r/ Ll1,....J ( II 0 I I u ~ .. LA! i'!..,ty &4 ";I!. CD e 'I. IO f l! • l ., C/~'f 'S"utL. ~C> -i N i m 1 Phone: 7{ ,!) -'f3/ .,. {(Jt> POI. "iJF. V ~ .!! :i .. 1 ..Q C) -0 "ii 'e l. C: C: a, -a • i C Fax: JablC1al,n .. IIS :8 C I '"C: i ct J ?l¢, ,.tf.,,J tl "l l " It ~ C \\--8 E !! j ca 5 ~ 0 ;;: ! f e ~ fl) ·sample# Color & Location 1-~saFeel! ca ..0 'C ::I 2 .c 15 Code (!)_· -0' 0 5 .UJ .. 0. )1.. Z_ .tn CL. Q. ( L-( 10 wl:-1-t-/Ze a 111 ( lilllc,t. rt:t.,-t.. X 'K ;;. { l ' 1',o ~ ~ ~ @,i.ll r.t-'2, 1 ) R., .. o f"\. J ~-fl..._ .... y s ~ ... '\ ~ l F,... ......... l -, ' l R---~-' \ J ' & /Oo W,H,•-t _ ~-"""' ( 6 tn -0 C:,. 'I.. II<. .~ -~ ' (l..,__.,._1.. . \ -< I~ -. . 10 .v \ n..,..,~ J ,/l J II \ I~ .,. 1. .. Rennquished bv"~ , _Al? Rece!Yed by; -v-,M~ ifum1muos1 Time: 2 J.try Datelrme: Cf -l .--/ 'i l 'I n, ' /'" '1/3/1'1 is·,~ Regular: 0 3 tn 5 days ~••na: fl-.JS~- Standard Rush: 0 24·hours ReOnquished by: !Received by: Da!efTfme: iDat,/Tlme: IEnd of Day Rush: D 10-Catlll.ing 90 -Dirt/Soll 180-Floor TIie 12x12 210-Mash a Glues 370 • Transi\8 Siding •-Amount of Homogeneous Material 20-Alrcell 100-Drywal 190-FtoorTie 9x9 280 • Parquet Mastic 380 -Vinyl Flooring Phplcal Asffpmenf 30-BlookTSI 110-JointC~. 200 -Tie Made 290 -Pipe lnsula1!0n 390 -Window Putty # 1 Damagad or slgnfflcantly damaged TSI. 35 -Blown In lnslllallon ,.~20 • Duct Overspray 210 • Gasllne Wrap 300 • Rolled Roofing 400 • Plas1edtlrywal # 2 Oamagad friable su:rlacltig ACM. 40 • Carpet Glue 130 -Elbow TSI 220 • Gasket Materials 310 • Roof Penelralon 410 -Wood Putty # 3 Signfflcantty damaged friable surfacing ACM. 50 -~ TIie 2x4 140 -Ellpansion Joint 230-Grout 320 • Rooting Paper 420 -Vapor Banler # 4 Damaged or slgn\ficanlly dam11ged friable misc ACM. 60 • Celling TIie 12x12 150 • ExleriDr stucco 240-HVAC Wrap 330 -Raolng Shingle& 430 -2K2 Ciellng TIie # 5 ACBM with l)Olenllal for slgnJficant damage. 70 -Comi,oslte Drywall/JC 160-Exterior Texture 250 • lntarlor Wall Plnlar 340-SOAC 440 • 2x1 Celling TIie # 6 ACBM with potential for damage. 80 • Cove Base Mastic 170 • Flmp-ooflng 260 • lnleriof Wa11T91dura 350 -Thin Set 460 • Cancnite Wall # 7 My remaining Mable ACBM or fml.ble suSOEri Ar-ra.u 380 -Translla Pipe 460-CemAnt ~w,11 w-• H. • l"ll"I LABS, INC. 9590 Chesapeake Drive, SUlte 5 Asbestos Survey Chain of Custody San Diego, CA 92123 1JVO#: '.Le>'-{ 1S" (619)474-8548 Fax:(858)412~05 CUSTOMER INFORMATION·-_ PRGJ.ECT-JNFQRM~llOfif ANAL YSIS·REQUESTED BIIITo:~',-.,k,.. l'D"L~tc:h., -.-.. , . iampledByy_ "~ [ .. ,1-&, </~~~ * Condition "ll"lll'Potentlal l-:-.-.:--..!!"..!J~Jt.:!:.,~::::..:~...ldlLL_,;,-l-~--61~~~::;;!S..-----L:.;..L::17-----f ACM Type A.ddrass:P5, .ti C° J,.L .Jh D ---·-n: (1 f "t -illJ.1,of\,l.r "-l<. (i U:llH" • ~ ~ r.-A.NtlA1 ~ ~~&l~~ ~ 1 9z..>af -s-u,t-2.,..c, --I! 1--------------+----..:-. ...... --..__.----------..a ., V !Ill Phone: ?/ t') -'131 ..,,. ((Jb POI. ~ 'i 2 ____ .....__ ....... ......., _ _....__ ___ ,._ _________________ ----V tD c Fax: 7,<> ""'f'11 ,, 'l ( ~a.tmt: _ . -g "'e f ..,__,..,__,.--... -------------------...... --0 t'a C ·sample# Code _ Color & Location _ •ADpro.: Sq Feet c, __ c {l,, ..,.. __ ... __ ..., ___________________ .., ____ _ b.J 'I--I.,...,..,_ '1 ft, Z> a.., Ft,L-,l l\ I• z> Fo~- ., ,r . II -b i ft.10/VI-I } I )1 ' \ I\ 1 \ \ Relinquished by:~~.A:;:::=-,,....J:·:::-12!::::=:::;:______ ~d by: • V "I A.;l ,;-..--Turnaround nme: 'J a,) 0 .. 11 a;D .. at_,em,_1m .. e .. : a;;;;;l-(;;;;;;;;.-.. 'J~-;a;;;;r:;.,1;;;.a--.-l .. 'fiiii&:;;;.r.,ai()&illliiliiiilliiliila-~D.;· a:;;;lallime;.;,. ;;,;;;,;:illiilli._a/•_~.,llfliil~a;/a;lall-=al•S-~ "-~-;i;;;.;;;a;;;;;;;;;;;;;;___, ____ -4Regular: 0 3 to 5 days f, ~t-1 Reffnqu'lshad by: ____________ _ Recetvedby:.______________ !Standard Rush: 0 24 hours DatefTime: 10-Gauking 20-Aircell 30-B!ockTSI 90 • Dirt/Son 100-Dr)WBII 110-JolntCmpd. 35 -Bluwn in Insulation 40 -Carpet Glue ~"-.! 20 -Duct Overspray 130 -Elbow TSI 50 -Cl!.iRng Tile 2X4 60-Caillng 111tl 12X12 70 • Composite Drywall/JC BO -Cove Base Mastic 140 -Expansion Joint 150 -EldllriorS\ucco 180-Exterior Texture 170-Fireproofing 180 -Floor TIie 12X12 190-Ftoor Tile N 200 -TIie Mastic 210-Gasllne Wrap 220 -Gasket Materials 230-Grout 240 -HVAC Wrap 2so -trtter1or wan Ptaater 260-lnlerior Wall Texture 270 -Masllcs & Glues 280 -Parquet Mntic 290 -Pipe lnaulation 300-Rolled Roofing 310 -Roof Penetration 320 • Roofing "8pei- 330 -Roofing Shingles 340-SOAC 350 -Thin Set 360 -Transite Pipe 370 -Transite Siding 380 -Vinyl Flooring 390 • Window Putty 400 • Plaster/DyYNall 410 -Wood Putty 420 · Vapor Barrier 490-2X2 Cell"111g Tie 440 -2x1 Calling Tile 450 -Concrete Wal End of Day Rush: 0 -Amount of Homogeneous Material Physlg;,I Assessment # 1 Damag,,d or signllican\ly damaged TSI. # 2 Damaged friable surfacing ACM. # 3 Significantly damaged frtable surraang ACM. # 4 Damaged OT slgnlfle.intfy damaged friable mlac ACM. # s ACBM wKh l)Otemlal for significant damage. # 6 ACBM with potential for damage. # 7 My remaining friable ACBM or friablA ,., ,.....,,.. A,..~. • I I \ i -H.M. l'l'l"l 'INt.:. Asbestos Survey Chain of Custody fjJ 9590 Chesapeake Dtive, Suite 5 San Diego, CA 92123 WO#: ;.J.D-<-( 1 c_;-- (619)474-8548 Fax:(858)412-3305 -Lab ID#: I \,<i, o 'b"'I CUSTOM£R. INFORMATION PRQ,n:CT INF_ORNl~TION. ANALYSIS REQUESTED BIii To:I.Q',sk, ~-i. Mch .,...., Sampled BYj ..u.-7 l ,.>ti, t./~~ * **p . I ACM Type --:;-.. I . _Condition otentia. Address:.:75-, JI Location: /'l~"l . Jiu.-.~,tr J'~l(.oCi . ~ s; t,;;,. L .. \h d \IJiLlt"' ForDamane • -· -N e 1S 6.r1.,,.l11~ I It. u 1ij • I"" .A_f'fr f. ,d L!.IY IYl ';/!. & t ·c: : -g_ Q) 0 .! q~f 'S'v'll-t 2.. .... C> "' ~ 16 co 0 N .! 0 ~ -V 8 R :E ..: Phone: 7/ &> -'111 .,,. l{Jb POI. ~ 'O u .0 OI -Q ii .. C C CII i IJ) & c C ca C JoblClalm #: V I j :8 C Q) ·c ¥ u, ii( • Fax: ?t O ---Cf"? I 1l "l f lU 0 i..: ~ 1.1. 'i e .s -g E ~ ·in II) ' u ·s: 3 _a e :6 -~ C ci5 ~ 0 Sample# Color & Location -Approx Sq Fee_t 0 cu 0 :J f I! .c Code .. C>: -0. 5 w 0 U-Z. Cl) I-. ~ C, Q. A. 2.J t ( C, (,) l..j it fl.-._ .......... ' IZ-~ (:,-P-1"-.J. ;L l,.< K ).,z__ lo t IL\.{ LL ~Go' d<; / 4. l ~n. 3 11'? Lu 1\-K P( K ~ 1-3 ll....~l"lA. '-( I I 1 ')_y V ('""') v-L ~ , A.. ~ l 11 t11 m ~ ' l i,t;' 1 It --,t!),.,, 7 I/ u t. !") 'lt--U, w t~M'1 -.g,1ee-v f4 2 C, ti\.."\ > J.. (._ 'l,a..r\,) I \ !')_ 1 I ' 0~ / f ~+. ..... ) \ \_ \ \ -•✓ '".l-'1 J.g~ EiJ lv1A--~ rc,A.\(' ~-s b-t, f).,-'L \ 1 \ <tD J .l \... /) l , ' n RelinQulshed by: ~ -,;? -Received by: ._r -1-~ Tum11round Time: z. 1)4-a ~ 4 __ , ___ , r -11/Pv { J 'I ~ I I'! It:"~ Regular: 0 3 to 5 days_ c, ~ Oatamme: Da'8/Tlme: -□ 1 A-Relinquished by: Recetved by. · Standard Rush: 24 hours ID ate/Time: Date/Time: _ End of Day Rush: □ 10 -Cauking 90-0irt/Soll 180 -Floor TIie 12x12 270 -Mastics & Glues 370 • Transite Siding -Amount of Homogeneous Material 20-Aireell 100-Drywa.D 190 -Floor Tile 9x9 280 -Parquet Mastic 380 -Vmyl Roering Physical Assessment 30 -Block TSI 110 -Jolnt Cmpd. 200 -Tile Mastic 29D -Pipe Insulation 390 -Window Putty # 1 Damaged ot signiftcantly damaged TS!. 35 -Brown in rnsulatiori ,~ 20 -Due\ Overspray 210 -GasNne Wrap 300 -Rolled Rcoflng 400 -Plaster/Orywall # 2 Damaged fr1abfe surfacing ACM. 40 -Carpet Gil.hi 130 -Elbow TSI 220 -Gasket Mstarials 310 -Roof Penetration 410 -Wood Putty # 3 Significantly damaged trlable surfacing ACM. 50 -~illng Tile 2x4 140 -Expansion Joint 230-Grout 320 -Roofing Paper 420 • Vapor Barrier # 4 Damaged or significantly damaged friable misc ACM. 60 -Celling Tile 12x12 150 -Elderlor Slut:ea 240 -HVAC Wrap 330 -Roofing Shingles 430 -2X2 CeiHng Tile # 5 ACBM with potential for significant Clamage_ 70 -Composite DryWall/JC 180 -Extal'l0r Texture 250 -Interior Wall Plaster 340-SOAC 440 -2x1 Cefllng TIie # 6 ACBM with potential for damage. 80 -Cove Base Mastic 170 -Fireproofing 260 • ln!erior WaN Texture 350 • Thin Set 450 • Concrete Wall # 7 Any remaining friable ACBM orfri"'h"" ~------· • ---· 360 -Transite Pipe 4A('l • ~,Aft'llft,.._e, b1--1-~--~ -~ (it) tt.M. PITT LABS, lNt; .. Asbestos Survey Chain of Custody 9590 Chesapeake Olive, Suite 5 San Diego, CA 92123 _ (619)474--8548 Fax:(858)412•33~5 CUSTOM-ER INFORMATION PRMCT 1NFC$M~TION BIii To:I.Q""\.,· ~ SVGJ. --~1, 0, ...... -,_ I' . Sampled By-J~,,. I .._I-Gt tJ-48-!1~ * Condlt~n . . Address_2. 5' "'.J.JI d location: ~ .CJLL wh /f f"I 1£\.l,.-,.,1.r 1~lc. ~ WilH" It) N Ch .r{ L l ,_,r l A CA..NtI.h1 ?..-CJ# '#. a, C, q~f af vtk 2.., ... c:, IQ Ill N E Phone: If t) -'131 .,.. l(Jc, PO#. Fax: 76¢ -Cf"ll tl 1 l JobJClalml: Sample# Code Color & Location ,.S I l-?-t,, ~h fj l"c:Jil ~ f\,.t, ~ 32.._ '2.7 C) I\. t-t t,o) "\ R 0-..A lt. 3J l \ 13'\ ..v .Y ....-L ~ Rer,nquished by: --~ -~ DatefTime: '1-~~{"7 Relinquished by: Date/Time: 10-Gauking 20 -AiroeU 30 • Block TSI IY uo 90 -D'lrt/SoB 100 • Drywall 110-Joint Cmpd. 35 -Blown in Insulation 40 -Carpet Glue , ~ 20 -Duct Overspray 130 -Elbow TSI 50 -~ling TIie 2x4 60 -Celling TIie 1b12 70 -composite Drywall/JC oo -cove Base Mastic 140-Expansion Joint 150 -Exterior SluCO) 160 -Exlltrior Texture 170 • Fk'eproofing ~~ \ \v . • by: Datef!ime: Received by: Dale/Tme: 180-Floor Tile 12x12 190 -Floor TIie 9x9 200 -Tie Mastic 210 -Gasline Wrap 220 • Gasket Materials 230-Grout 240 • HVAC Wrap 250 • Interior Wall Plaster 260 -Interior Wal Texture ~ V ID "O C 'a-, Q) I V Cl 111 -g E ~ -Approx SQ Feet 0 cu r 0. _Q_ ~l)~ fl-r<- • . . . . /") r, ... v r/Lt~ I ;-,,b/11 1s,,\ 2M • Mastics & Glues 370 -Tran&ile Siding 280 -Parquet Mastic 380 -Vinyl F1ooring 290-Plpe lnaulallon 390 • Window Putty 300 -Rolled R<!Ollng 400 -Plaster/D,y.t,,all 310 -Roof Penelration 410 • Wood Putty 320 -Roofing Paper 420-Vapu-8anief' 330 -Roofing SNnglea 430 -2x2 ceuln; TIie 340-SOAC 440 -2x1 Celling Tile 350 • Thin Set 450 -Conaete WaH WO#: ~'{15'" rLab ID#: lla'£o'li'1 ANALVSJS-~EQUESTED ._..Potential ACM Type '-ForDamaaa ., E -u IE e Ci' C: a I 0 \ j Q = -a • g .!! .,, m II o. =-Q) :E < ... :iS 01 .2 'ii C a, ·a iii l: C 0 C ~ ·c: u I ,c vt ! 0 I.: u. ii 0 -~ ID .c ' ~ u :5 j .0 t; ca C --~ .!!? ~ if 0 ::, > w z (I) :E .. Q. Q. Q. i , .. Tumi9roynd Time: ~'?' Regular: 0 3 to 5 days Standard Rush: 0 24hours 'rlJ-( End of Day Rush: □ ... Amount of Homogeneous Material Physir;al Assessment # 1 Damaged O!' signiflcantty damaged TSI. # 2 Di;:maged-lriabl& surfadng ACM. # 3 Signiti~ damaged friable surfacing ACM. # 4 Damaged m signfflcar,\fy damaged friable misc ACM. # 5 ACBM with potential fer significant damage. # 6 ACBM with potential for damage. # 7 Arrt remaining friable ACBM or fria'-1-~··---• • - 360 -Transite Pipe 460 .. CAft'd:11"" aa--1:.. -.. -•