HomeMy WebLinkAbout2200 AFTON WAY; ; CB163719; PermitT
_City of
Cailsbad.
I mstaenva ermit
P h nt Date:, 06/15/20 18 Permit No: CB163719
Job Address: 2200 Afton Wy
P&mit Type: BLDG-Residential Work Class: Demo Status: Closed - Expired
Parcel No: .1675314500 Lot #:' Applied: 09/30/2016
DEV14053 valua~ion: :$ 12,825.12 Reference #: Issued: 03/30/2017
Occupancy Group: Construction Type Permit
Finaled:
# Q~velling Units*' _1 Bathrooms: Inspector: PYork
Bedrooms: Orig. Plan Check #: Final
Plan Check #: Inspection:
Project Title:~ "'AFTON WAY
D,escription:,~ PRESIDIO: DEMO 2082 SF SFD AND TWO SMALL SHEDS ON PROPERTY INCLUDING DRIVEWAYS AND HARDSCAPE
Contractor:
PEBBLE CREEK COMPANIES
619-938-0312
AMOUNT. ''FEE,
BUILDING PERMIT FEE $2000+ $140.02
BUILDI~G STANDARDS FEE $1.00
,STRONG [ViOTIOI~-RESIDENTIAL $1.67
SWPPP INSPECTION FEE TIER 1 - Medium BLDG - $232.00
SWPPP:PLAN REVIEW FEE TIER I - MEDIUM J $55.00
Total Fees.,,, ', $ 429.69 $429.69 $0.00 Total Payments To Date Balance Due:
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 a nd any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section
3.32.030. Failure to.timely !ollow tha,t procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their
imposition.
Yoware hereby FURTHER NOTIFIED that your right to protest the specified fees /exactions DOES NOT APPLY to water and sewer connection
fees a nd capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this
ct. NOR DOES IT APPL~ to any fees /exactions of which you have previously been given a NOTICE similar to this, or as to which the ~proje
statute of limitation has previously otherwise expired.
Buildi6g Divisioii
1635,Faraday Avenu6; Carlsbad CA 92008-7314 1 760-602-2700 760-602-8560 f www.carlsbadca.gov
~ry
HO
i
THE F - OLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: [:]PLANNING ENGINEERING BUILDING [—I FIRE E] HEALTH El HAZMATIAPCD
Building Permit Appliccition Plan Check No. c_% I G'J"( k9
Est. Value Cit 1635 Faraday Ave., Carlsbad, CA 92008
-_yof -Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit
_ffl
email: building@carlsbadca.gov sbad ..,cc www.cadsbadea.gov I Date q So ISWPPP
JO I B ADDRESS 2200 Afton Way
SUffU/SPACE#/UNrr#
NIA
A4
167, 531 45 00
CT 6,PRQJECT # LOT # PHASE # 0 BATHROOMS BUSINESS NAME CONSTR.TYPE -03
14-05 CT1"6. 1 10 lots
1#01FUNITS I
8 DIU
I#BEDROOMS
3 3 N/A Demo
OCC. GR~P
PES.CRIPnON,OFWORV- IncludeSquafeFaetoilAffectedArea(s)
Demohs'h'in existing 2082 square foot home and two small sheds on property including driveways and hardscape.
EXLSTING USE PR POSED USE GARAGE (SF) PATIOS (SF) DECKS(SF) FIREPLACE AIR CONDITIONING IFIRESPRINKLERS
...- I Residenti'illi' Residential I I YES[3#. NO01 YES[:]NO[::]l YES[:]NOE:]
APPUCANT NAME
P_
Gary Arnold PROPEMOVMER14AME Presidio Pebble Creek Carlsbad 8, LLC
ADDRESS
301 West 28th Street, Su Re A
ADDRESS -
301 West 28th Street, Suite A
CITY STATE Zip CITY STATE ZIP
National Cltv CA 91950 National Citv CA 91950
PHONE FAX PHONE
619-938-031~ 619-938-0312 N/A
EMAIL
NiA
EMAIL
NIA
DESIGN PROFESSIONAIL Ronald Holloway, BHA Inc. 00INTIRACTOR BUS. NAME
Pebble Creek Companies
ADDRESS
5115 Avenida Encinas, Suite L
ADDRESS
301 West 28th Street Suite A
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA 92008 National Citv CA 91950
PHONE FAX PHONE
.,,760-931-8700 760-931-7780 619-938-0312
EMAIL EMAIL
gary(cDPebblecreekcompanies.com
LIC # STATE UC.# CLASS M BUS LIC.#
RCE 29271 931309
I
1 A& B 1,2LAq0_4 I
equires a permit to construict, after, improve, demolish or a r% structure, prior to its issuance, also requires the
ursuant to the provisions of the Contractor's License Law
- er commending with Section 7000 of Division 3 of the basis for the alleged exemption. Any violation of Section FOR3115 by any applicant for a permit subjects the applicant to a
rliollowiy(ci),bhaincsd.con
STA7
(See. 703L5 Business and Professions Code: Any City or County which r
app, icant for such permit to file a siced statement that he is licensed p
Bus.
I ness and Professions Code) or at he is exempt therefrom, and the
civil Denaltv at not more an five hundred dollars 1550011). IOWA=
Workers' Compensation Dectaration: I hembyafflfln undairpenaffyolpe#wy one offt IbUowing decI&aV6r=
I have and will maintain a certificalle of consent to self4nsure for workers! compensation as provIde*d by Section 3700 of the Labor Code, for the performara of the Mork forwhich this permit is issued.
I hava and will maintain workers'compensation, as required by Section 3700 of the Labor Code, for the perfornriance of the work for which this permit is issued. Myworkers'compensation insumnoe carrier and policy
number are: insurance Co. State Compensation Ins Fund Policy No. 119M6715 Expiration Date 10101117
Th* section need not be completed 11 the permit Is for one hundred dollars ($100) or law.
tn Certificate of Exemption: I certify that in the performance of the work for which this pennit is Issued. I shall not employ any person in any manner so as to becorne subject to the Workers' Compensation Laws of
Calbmia. WARNING: Failure to secure workers' compensation coverage Is un awful, and shall subject an employer to criminal penalties an If dvil fines u p to one hundred thousand dollars (&100)(100), 1 n
addition to the cost of compensation, damages as provided for in Section 3706 of thL, Lallor code, interest and attorneys fees.
)K CONTRACTOR SIGNATURE [3AGFNT DATE
I N 141 ii
I hereby affirm that I am exempt Irom ContracWs Lkense Law for ft biloWng riwon: 1, as owner at 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 Contractors -
License Law does riot apply to an wrier ' 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. 11, 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).
1, as own er of th a property, am exclusively contrad ng with licensed contractors to construct the project (Sec. 7044, Business and Piofesslons Code: The Contractors License Law does not apply to an owier of
property who builds or improves thereon, and contracts for such projects with contractDr(s) licensed pursuant to the Contractors Lioem Law).
El' I am exempt under Section and Professions Code for this reasom
1. 1 personally plan to provide the major labor and materials for construction of the proposed properly Improvement Dyes ao
2~ I (have I have not) signed an application for a building permit for the proposed work.
1 have contracted YAth the fbIlowing person (firm) to provide the proposed construction (include name address / phone / contractors' III number):
1 plan to provide podions of the work, but I have hired the following person to coordinate, supervise and provide the major viork (inclUcle name / address phone foontractors' license number):
1 Wil provide some of the work, but I have contracted (hired) thefollowing personsio provide the work Inilicated Vnclude name/ address / phone / type of work):
ER 51G 3ENY DATE ePROPERry OWN MATURE []AG
1. 1
%
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanfier Hazardous Substance Account Act? 0 Yes 0 No
~
s the applicant or-future building occupant required to obtain a permit from the air pollution control district or air quality management disMW 0 Yes 13 No
s the facility to be constructed within 1,000 feet of the outer boundary of a school site') 0 Yes 0 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.
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 31597 Of Civil Code).
lender's Name 0 L,.h4V_?_ LendeesAddress
I ;6*tj6I ~awe read the application and stateWthe above Information is oDnect and that the informatim onthe plans isa=rate. I agree Io com*wb all Coardnances and State Imn mWngto building construction.
cfthe Cftyof CarSbadl IDerder upon lihe above mentimed! property for inspection purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLE~S THE CITY OF CARLSBAD I hereby authorize
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND E)FENSES WHICH MAY IN ANY WAY ACCRUE AGAJNST SAID CrTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMrr.
OSRk- An OSHA permit is required for exmiiations mw 51Y deep and dernotitim or conodon of structures over 3 stories in height.
DPIRATIOR Every parmit wied by 0* Building Official under the provisions of this Code shaM expire by hitatim and becorne null and void I the building or work authorized by such peft is not commencad vAthin
180 days from the diate of such perind or if the building or work arthorlized by such permit Is suspended or abandoned at any tirne after the work is commenced for a period of 180 days (Sectim 106.4A Urftm Building Code).
eAPPUCANT-S SIGNATURE Z— t ZO( DATE N- 01—~ L
Permit Type:.' BLDG-Residential Application Date: 09/30/2016 Owner:
'Work'Class: Demo Issue Date: 03/3012017 Subdivision: V
Status: Closed - Expired Expiration Date: 11/13/2017 Address: 2200 Afton Wy
Carlsbad, CA
IVR Number: 717461
-Scheduled Actual Inspection Type Inspection No. Inspection Status Prima~y Inspector Reinspection Complete Date - Start bate
04/14/2017 04/14/2017 BLDG-SW-Pre-Con 019934-2017 Passed Michael Collins Complete
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
V
June 15, 2018 Page 1 of 1
IS,
CITY' F
.,CARLSBAI)
PLANNING DIVISION
BUILDING PLA ' N CHECK
APPROVAL
. P-29
DeVelODMent Services
Planning Division
1635 Faraday Avenue
(760) 602-4610
www.carlsbadca.eov
DATE: October19,2016 PROJECT NAME: Afton Way PROJECT ID: CTi4-06
-3719 SET#: I ADDRESS: 2200 Afton Way PLAN CHECK NO: C13 16
APN: 167-531-45
This plan check review is complete and has been APPROVED by the
Planning Division.
By: Shannon Werneke
A Final Inspection by the Planning -Division is required Yes No
:%%.Ydu may also have corrections from one or more of the divisions listed below.
`~pproval fiom these divisions may be required prior to the issuance of a building
^lei Pffmit. Resubmitted plans should include corrdctions from all divisions.
Al
Y This plan check review is NOT COMPLETE. Items missing or incorrect are
listed on the attached checklist. Please resubmit amended plans as
k A '. required.
Plan Check APPROVAL has been sent t6: ga!y@pebblecreekcomDanies.com
Tor questions or clarifications on thb attached checklist please contact the following reviewer as
marked:
PLANN ING:, -ENGINEERING FIRE PREVENTION
760-602-2750 760-602-4665'
F-] Chris-Sexton F1 Chris Glassen F] Greg Ryan
760-602-4624 760-602-2784 MO-662-4663
Chris.Sexton@carlsbadca.go Christopher.Glassen@carisbadca.go Qre0,ory.Ryan@car1sbadca.90
Gina Ruiz ValRay Marshall F-] Cindy Wong
760-602-4675 760-602-2741 760-602-4662
Gina.Ruiz@carlsbadca.go VaiRay.Marshall@carlsbadca.gov Cynthia.Wong@carisbadca.gov
Z Shannon Werneke F-] Linda Ontiveros 136minic Fieri 760-602-4621
'Sh nnon.Werneke@carlsbadca.gov 760-602-2773
Linda.ontiveros@carlsbadca.gov
760-602-4664
Dominic.Fieri@carisbadca.gov
I Page'l of 2 07/11
DevelODment Services
Land Development Engin rin
':,,ge 1635 Faraday A
(760) 602-2750
www.carlsbadca.gov
PROJECT NAME: Afton Way PROJECT ID:CT 14-06, HDP 14-05, HMP 15-03
ADDRESS: 2200 Aftori Way, Carlsbad, CA 92008 APN: 167-531-45, 167-250-06
The project is (6heck-one): El New De'velopment El Redevelopment Demolition Plan
The tot al propose . d disturbed area is: 13,068 ~2 0.3 acres
- 77
The total proposed newly created and/or replaced impervious area is: N/A ft2 acres
'If your project is covered by an approved SWQMP as part of a larger development project, provide the project ID and the
SWQMP # of the larger development project:
Proje6t ID Swamp#:
Then, go. to Step 1: and. follow the instructions.' When completed, sign the form at the end and submit this with your
application to the city.~
STORM WATER STANDARDS F i t k_C y of' QUESTIONNAIRE Cd, sWd, E-34
a 0 t pollutants that may be generated from development projects, the city requires that new -
development and'significant redevelopment priority projects incorporate Permanent Storm Water Best Management
.Practices (BMPs) into the project design per Carlsbad BMP Design Manual (BMP Manual). To view the BMP Manual,
refe~to the Engineering'Standards (Volume 5).
This I questionnaire, must be -completed by the applicant in advance of submitting for a development application
(subdivision, discretionary permits and/or construction permits). The results of the questionnaire determine the level of
storm water standards that must be applied to a proposed development or redevelopment project. Depending on the
outcome, your project will either be subject to 'STANDARD PROJECT' requirements or be subject to 'PRIORITY
DIEVE.LOPMEN - T PROJECT' (PDP) requirements. I
I
Your responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City
staff has responsibility for making the final assessment after submission of the development application. If staff
determines that the questionnaire was incorrectly filled out and is subject to more stringent storm water standards than
initially assessed by you, this will result in the return of the development application as incomplete. In this case, please
make the changes to the questionnaire and resubmit to the city.
If you are unsure iibout the meaning,of a question or need help in determining how to respond to one or more of the
questions, please seek assistance from Land Development Engineering staff.
A completed an~'signed: EIuestion'naire must be submitted with each development project application. Only one
~ompleted and signed questionnaire is required when multiple development applications for the same project are
submitted concurrently.
.4
E-34, Page I of 4 REV 02/16
ig *Rm—" ~WRM- g7
Fi4
To determine if your project is a "development project", please answer the following question:
YES NO
Is your project LIMITED TO routine maintenance activity and/or repairrimprovements to an existing buil
or structure that do not alter the size (See Section 1.3 of the BMP Design Manual for guidance)?
If you answered "yes" to the above question, provide justification below then go to Step 5, mark the third box stating ."my
project is not a 'development project' and not subject to the requirements of the BMP manual' and complete applicant
information.
Justification/discussion: (e.g. the project includes only interior remodels within an existing building):
If you answered "no' to the above question, the project is a 'development project', go to Step 2.
"c 7, "ini
1~ 30-
IL RU E
To determine if your project is exempt from PDP requirements pursuant to MS4 Permit Provision E.3.b.(3), please answer
the following questions:
your project LIMITED to one or more of the following:
YES NO
1 . Constructing new or retrofitting paved sidewalks, bicycle lanes or trails that meet the following criteria:
Designed and constructed to direct storm water runoff to adjacent vegetated areas, or other non-
erodible permeable areas;
F-1 Designed and constructed to be hydraulically disconnected from paved streets or roads;
Designed and constructed with permeable pavements or surfaces in accordance with USEPA
Green Streets guidance?
Retrofitting or redeveloping existing paved alleys, streets, or roads that are designed and constructed in
E] 91 accordance with the USEPA Green Streets guidance?
Ground Mounted Solar Array that meets the criteria provided in section 1.4.2 of the BMP manual?
If you answered "yes" to one or more of the above questions, provide discussionfjustification below, then go to Step 5, mark
the second box stating "my project is EXEMPT from PDP and complete applicant information.
Discussion to justify exemption ( e.g. the project redeveloping existing road designed and constructed in accordance with
the USEPA Green Street guidance):
if you answered "no" to the above questions, your project is not exempt from PDP, go to Step 3.
Page 2 of 4 REV 02/16
E-34 REV 02/16 Page 3 of 4
i N, .~4; -
E
To determine if your project is a PDP, please answer the following questions (MS4 Permit Provision E.3.b.(1)):
YES NO
-ot -is your project a new development that creates 10,000 square feet or more of impervious surfaces
collectively -over the entire project site? This includes commercial, industrial, residential, mixed-use,. El El
and public development projects on public or private land.
Is your project a redevelopment project creating and/or replacing 5,000 square feet or more of
impervious surface collectively over the entire project site on an existing site of 10,000 square feet or
El FKI more of impervious surface? This includes commercial, industrial, residential, mixed-use, and public
development projects on public or private land.
Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more
of impervious surface collectively over the entire project site and supports a restaurant? A restaurant is
*a facility that sells prepared foods and drinks for consumption, including stationary lunch counters and
refreshment stands selling prepared foods and drinks for immediate consumption (Standard Industrial
."Classification (SIC) code 5812).
Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious
surface collectively over the enfire project site and supports a hillside development project? A hillside 0 Z)
development project includes development on any natural slope that is twentya-five percent or greater.
5., Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more
-of impervious surface collectively over the entire project site and supports a parking lot? A parking lot Is
0 FRI a land area or facility for the temporary parking or storage of motor vehicles used personally for
business or for commerce.
.6. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more
-'of impervious surface collectively over the entire project site and supports a street, road, highway
11 FRI freeway or driveway? A street, road, highway, freeway or driveway is any paved impervious surface
used for the transportation of automobiles, trucks, motorcycles, and other vehicles.
.7: Is your project a new or redevelopment project that creates and/or replaces 2,500 square feet or more
_bf.impervious surface collectively over the entire site,- and discharges directly to an Environmentally
Sensitive Area (ESA)? , "Discharging Directly to" includes flow that is conveyed overland a distance of El
200 feet or less from the project to the ESA, or conveyed in a pipe or open channel any distance as an
isolated flow from the project to the ESA ae. not commingled with flows from adjacent lands).*
Is your project a new, development or redevelopment project that creates and/or replaces 5,000 square
"feet or more of impervious surface that supports an automotive repair shop? An automotive repai . r . El 0 sh op is a facility that is categorized in any one of the following Standard Industrial Classfflcation (Sic)
codes: 5013, 5014, 5541, 7532-7534, or 7536-7539.
1 Is your project a new development or redevelopment project that creates and/or replaces 5,000 square
feet or more of impervious area that supports a retail gasoline outlet (RGO)? This category includes F-3 R] RGO's that meet the following criteria: (a) 5,000 square feet or more or (b) a project Average Daily
Traffic (ADT) of 100 or more vehicles per day.
Is your project a new or redevelopment project that results in the disturbance of one or more acres oi land
prid are expected to generate pollutants post construction? El El
Is your project located within 200 feet of the Pacific Ocean and (1) creates 2,500 square feet or more of
impervious surface or (2) increases impervious surface on the property by more than 10%? (CMC 13 -.,21.203.040)*
If you answered "yes" to one or more of the above questions, your project is a PDP. If your project is a redevelopment
project, go to step 4. ~ If your project is a new project, go to step 5, check the first box stating "My project is a PDP
and complete applicant information.
Ifyou aniwered "no" to all of the above questions, your project is a 'STANDARD PROJECT.' Go to step 6, check the
-second box stating "My project is a 'STANDARD PROJECT'..." and complete applicant information.
E LOP K 111 ME
I MWIS
Complete the questions below regarding your redevelopment project (MS4 Permit Provision E.3.b.(2)):
YES NO
Does the redevel opment project result in
'
the creation or replacement of impervious surface in an amount
of less than 50% of,the'surface area of the previously existing development? Complete the percent
-im pervious calcula'ti6n'below-
,Existing impervious area (A) sq. ft.
Total proposed newly ~reated or replaced impervious area (B) sq. ft.
Percent impervious area created or replaced (B/A)*1 00 %
,If you answered "yes", the structural BMPs required for PDP apply only to the creation or replacement of impervious
surface and -not the entire development. Go to step 5, check the first box stating "My project is a PDP ..." and complete
applicant information: . . - . . 4 I I -
' ' ' 'lf'ybu As w~ered "no, the structural BMP's,required for PDP apply to the entire development. Go to step 5, check the
check the first box stating "My project is a PDP and complete applicant information.
L
A AM- 141 TT ri R'. i~
El My-project is
I
a PDP and must comply With PDP stormwater requirements of the BMP Manual. I understand I must
.preliipre a Stol rm Management Plan (SWQMP) for submittal at time of application.
My project' is a 'STANDARD PROJECT' OR EXEMPT from PDP and must only comply with'STANDARD PROJECT,
stormwater requirements of
'
the BMP Manual. As part of these requirements, I will submit a "Standard Project
Requirement Checklist Form E-36'and incorporate low impact development strategies throughout my project.
-Note For projects that are close to meeting the PDP threshold, staff may require detailed impervious area calculations
and exhibits to verify if 'STANDARD PROJECT' stormwater requirements apply.
My Project is NOT a,'development project' and is not subject to the requirements of the BMP Manual.
Applica;t Infonmation. and Signature Box
Gary- Arnold Applicant Name: Applicant Title: Operating Manager
Ro
Applicant S ign ature:, Date: 7-1 Z01
Environmentally Sensitive Areas Include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special
Biological Significance by thei State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodiest
designated with the RARE beneficial use by the State Water Resources control Board (Water Quality Control Plan for the San Diego Basin (1994) and
amendments); areas designated as preserves or their equivalent under the Multi Species Conservation Program within the Cities and County of San Diego; Habitat
Management Plan; and any other equivalent environmentally sensitive areas which have been identified by the City.
r
This Box for City Use Ciniv
4.
City Concurrence:
YES NO
El
By:
Date:
Project ID:
71
"~-34 Page 4 of 4 REV 02/16 7
~Al
I
AWIML Development Services
Building Division City Of—
DEMOLITION
'REQUIREMENTS 1635 Faraday Avenue
760-602-2719 ..,.Ca'flsbad B-9 www.carlsbadca.gov
The following items must be completed prior to issuance of a demolition permit.
7.
i~( 7com'pleted Application and Plans: A demolition permit may only be issued to the owner
of the property or the State Licensed Contractor that is doing the work. An application and
Jour.(4) sets of plans should be submitted. Building, Planning, Engineering and Fire
divisions will review and comment/approve the submittal.
-Completed. Storm Water documents required by the appropriate Tier level as
determined,by the extent of construction.
TO BE
I.V SUBMITTE'D
PRIOR TO, '0 "-'.,-A Mobilization Plan, outlining the schedule for demolition, shall be provided to the
PERMIT. Building division after the pre-construction meeting with the CM&I division.
L4tter from Property Owner: The contractor must provide a letter, signed and dated by
the property owner, giving permission for the building to be demolished.
Demolition Asbestos Certification: This certification must be completed, signed and
have the correct square footage of the structure being.demolished, as well as its use. If
asbestos remediation is required, proof of application t6 the APCD 'Must also be provided.
Asbestos 6r lead paint remediation must occur prior to issuance f a demolition permit by
the7Cit
TO BEf
SUBMITTE
To San Diego Gas and Electric: Applicant must provide a letter from San Diego Gas and PRIOR
T Electric stating that the utilities have been disconnected. PERIVII
Waste Management Plan: Comply with Green Code waste disposal and recycling
..-.management program (50%). Sec. 5.408.1 / 4.408. Complete the attached B-59, Waste
_Management Plan.
N/A Public Property: If applicable provide plans and details demonstrating measures to
.-protect public property and walkways.
Additional items-that will be required or discussed in review are:
Water Agency: Arrange for appropriate Water Agency to remove water meter
unless construction of replacement structure is to begin shortly.
The Planning Division will determine if the structure is in the Village Review
area, the South Carlsbad Review area, the Coastal Zone or if discretionary
mitigation conditions apply. (760) 602-4610
A
'The Land Development & Engineering Division will determine if a Haul
-of-Way Permit or Storm Water Permit is required. (760) 602-Route, Right
2773, 602-2775 or 602-2741.
Fire Department may need the use of the building for training purposes.
.(760) 602-4665.
Page 1 of 2 Rev. 01/2016
-Received Fee/ Rec'eiilpit
Notification .0 ~Entired- 'Sictor
L
MAR 0 Nil
CAN"
_E. 1~
el
Cain,,, Teresa
From: NoReply@sdcounty.ca.gov,
Sent: Friday, January 20, 26) 7 1:5Z PM'..
To: Cain, Teresa
-p000l 5iP -sidio is,Ready for Pay~~ent Subject: Revised Asbestos Record APCD201T!ASB- re
Processing
The following asbestos record has been revised f~r revised demolition start date
-Facility Details
Facility Name: Presidio
Facility Address: 2200 AFTON WAY, CARLSBAD, CA; 92008
Revision Number: 1
Payment Method:Credit Card
Check Number:N/A
L Payment Amount:50.08
Record updated by LHAUCK
'SAN DIEGO AIR POLLUTION CONTROL DISTRICT'
10124 OLD GROVE ROAD, SAN DIEGO, CA 92131
PHONE (858) 586-2650 FAX (858) 586-2651
FOR APCD USE ONLY
Postmark Received Fee/ Receipt
Notification # Entered Sector
Inspector Assigned/Date
NOTIFICATION OF ASBESTOS RENOVATION OR DEMOLITION OPERATIONS
BTS Equipment Unlimted, I6c. Completed by: ..RONNIE SWAIM JR Company
0 Original ' E] Cancellation El Courtesy/ El Other(specify):
N I 31.11FIC. I ION Revision El Change in asbestos amount [2 Change in start/end date ndicate type of revision)
F .
(greater than 20%)
KI'D&molition El Ordered Demolition Ej Renovation (removal)
PR03ECT TYPE
Emergency Removal Emergency Demolition El Planned Renovation (annual)
FACILITY INFORMATION
Facility Name:
4%
Address: 2200 AFTON WAY Cross Street:
City:,' CARLSBAD Zip Code: 92008
'Facility owner: PRESIDIOTEBBLE -CREEK CARLSBAD 8, LLC (GARY ARNOLD)
Ad'dress:" i01W28TH,*SUITEA
City:'- NAT . ION~L CITY State: CA Zip Code: 91950
Contact: Title: Phone No: GARY ARNOLD PRESIDENT 619-818-3584
-Building Size (sq. ft): Building Age (years): Number of Floors: Number of Units: 0 2082 59 2
Building prior/present El Commercial El Hospital El Industrial El office El K-12 School use: 0 Public Bldg N1 House/Condo El Ship El Univ/College El Other
PR63ECT INFORMATION
Asbestos Survey Is Asbestos Present?, Will the asbestos be removed? Is the building to be demolished?
Performed?*
0yes- E]No~ 0 Yes CR Nor E3 Yes El No ]KI Yes [:1 No
4, Friable Category I Category 11 Total
4 ~7 .Asbestos
Pipes: Pipes: Pipes:
Aiiiount to be
r~moved-'.' Surface Area:. ~urface Area: Surface Area:
~(sq/ln ft): Facility Component: Facility Component: Facility Component:
,Revised Amounts
(if a vi sion)
Asbestos Removal Start Date: Demolition Operation Start Date: 2/6/2017
,Asbestos Removal'End Date: Demolition Operation End Date: 3/10/2017
- For revisions only For revisions only
'Revised Start Date: Revised Start Date:
,Revised End Date: Revised End Date: 3/31/2017
Renri Contractor: Name: Phone No: CSLB License#:
Aadress: City/State/Zip: Site Supervisor:
Demolition Contractor. Name:BTS Equipment Unlimited, Inc, FP one NO: 619-324-7065 7FSLB License#: 907777
Add.ress: 13465 Camino Canada #106-501 City/State/Zip: El Cajon/CA/92021 I Site Supervisor: Bryce 4
*Asbestos Sunieys are required prior to Renovation and Demolition, however the actual survey is not required to be submitted with the notification.
.SDAPCD -SUBPART M - Rule 361.145 Page 1, of 2
04/2010
NOTIFICATION OF ASBESTOS RENOVATION OR DEMOLITION OPERATIONS'
Waste Transporter#1: Waste Transporter#2:'
Name: BTS Equipment Unlimited, Inc Name:
Address: 13465 Camino Canada #106-501 Address:
City/State/Zip: El Cajon/CA/92021 71 City/State/Zip:
Contact Person: Bryce Phone: 619-454-5809 Contact Person: Phcrne:
Waste Disposal Site (Landfill): Name: EDCO Disposal
Address: 6670 Federal Blvd City/State/Zil5:, Lemon,Grove/CA/91945
Contact Person: Lupe Phone: - .619-287-7555
Check the appropriate procedures and analytical methods - used to dete'c't the presence'of- Asbestos Detection Procedureo asbestos containing materials.
Survey Inspection [I TEM El PCM
Bulk Sampling [I PLM El Other:
Describe work practices and engineering controls to be used. Check applicable methods below:'
El Water El Demolition w/roofing r~nateri*als'in place, [:1 Skid Loaders/bobcats/Top Loaders
Amended Water using sledge hammers. Terminator
;M
Roofing Cutting Saws El Axes 0 Shovels El Implosion
El High Pressure Water Blast E] Demolition w/Cat I Floor tiles in place. Explosion
El Infrared Machines El Ice Chippers Ej Pry.Bars El Negative Air Machines.-
El Cranes (wrecking ball, El Bulldozer El Full Containment
clamshell, bucket) El Intentional Burning El 3 Stage Decohl-
El Zamboni El Backhoes Ej Glove-Bag
El Bead Blast El Other: El Critical Barriers
El Floor Buffer
For Ordered Demolition provide a copy of the order and complete the in formation below:
Agency Name: Authorizing Person: Title:
Date of Order: Date Ordered to Begin: Phone:
Describe actions to be followed if unexpected asbestos is found during demolition or
Contingency Plan removal or asbestos material becomes disturbed, crumbled, pulverized or reduced to
I powder.
If unexpected hazardous materials are believed to be found, said work will be stopped. BTS'jobsite foreman will notify BTS' office wfic
will then advise the General Contractor of current findings. Hazardous survey-will then be conducted by certified lab to performed'
testing to identify hazards where a plan for removal will be created if t~st results c~mel b~ck positive for ha~ardous materials.
I certify that an individual trained in the provisions of this regulation (CFR Part 61', Subpart M)
Training Certification will be on site during the removal and evidence that the required training has been accomplished-
by this person will be available for inspection during n6rmal business hours.
Date: Print Name: Si nature~- Ronnie Swailli~,---9
3/7/2017 (Owner/operator) RONNIE SWAIM JR (o.ner/operator) j~
Information Certification: I certify that the above information is correct..
late Print Name: Signature: -Ronnie
3/7/2017 (Owner/Operator) RONNIE SWAIM JR (Owner/Operator) - Swaim ir
Original notifications are to be submitted to the District at least 10 working days prior to removal or demolition. Revised notices are to be submitted as
soon as possible but no later than the original start date. Original notifications cannot be accepted without the required fee(s) (Rule 40(f)(2)),'however
revised notifications will be accepted without the required fee provided the fee is paid prior to the start,date of the original not-ification..1-
SDAPCD -SUBPART M - Rule 361.145 Page 2 of 2
-_-jPkOJE . CT-INFORM - ATION
~Asbestos. Survey ls.Asbestos Present? Will the asbestos be removed? Is the building to be demolished?
,Performed?. .- .
K[Yes [:].No. -E3*Yes' 0 No El Yes [I No KI Yes [I No
'Friable Category I Category 11 Total
At6istos
Pipes Pipes: Pipes:
to be~ S6rface,Area:. Surface Area: Surface Area .~removed k
,,(sq/lrrft)::,, Facifity, Component.: Facility Component: Facility Com~ponent:
:Ftevised Amounts
'0f.
stos Remowil'Start Date.7 Demolition 00eiration Start Date: 2/6/2017
Asbestos Removall-End Date: Demolition Operation End Date: 3/31/2017
Foe revisions only For revisions only
Rivised;Start Date: Revised Start Date:
Revised,End:Date:, Revised End Date: 4/24/2017
.Removal Contractor:, Name: Phone No: CSLB License#:
Ad [dress: tate/Zip: City/S —TSite Supervisor:
Demolition tontra;or~.Name:BTS Equipmenit:lUntimited, Inc I Phone No: 619-524-7065 CSLB License#: 907777
A4aressiY
.13465 Ca6mino:Cafiada #106-501 City/State/zip: El-Cajon/CA/9202ITSite Supervisor: Bryce
FOR APCD USE MLY
'SAN DIEGOAIR PrOLLUTION-CONTROL DISTRICT
10i24 OLD iGROVE ROAD, SAN DIE GO, CA-9.2-131
PIHONIE (858) 586;-12650 FAX (B58) 586-2651
N0TIFIcATioN'OF ASBESTOS RENOVATION OR DEMOLITION OPERATIONS-
Completed by,,. RONNIE SWAIM JR Company BTS Equipment Unlirrited, Inc.
[:].Original 0 Cancellation El Courtesy El Other(specify):
NOTIHICATIO'K. Revision 0 Change in asbestos amount 21 Change, in siart/t~ Pindicate ty0e of ie4lisijon) (g reater than 20%)
Pk63 ECT TYP'
KI Deryioliti6n E] Ordered Demolition Renovation ~(removal)
E]Erherg6nc Removal, El Emergency Demolition 0 Planned Renovation. (annual) y
FACILITYIN FORMATION
Postmark ceived ee/ Receipt
Notification # Entered Sector
Inspec tor Assigned/Date
1.
Address: -'22000AFT.ON WAY Cross Street:
Clt~: - C~kRL~BAD Zip Code: 92008
.Fadlkyowne'r: PRtSIDIOPEBBLE CREEK CARLSBAD 8, LLC (GARY ARNOLD)
3 01,W28TH,SUTTEA
'Icity .'NATIONAL State: 'CA Zip Code: TY §1,950
~C o**ntact:' Tide Phone. No ~GARYARNOLD PRESIDENT 619-818-3584
B.Lilildi.ng ~Siie (s4.ft),::
2082
'Building Age (years): Number of Floors: Number of Units:
.59 2 0
Building prior/present,
ijs!e:._
- Commercial [].'Hospital [j,Indu I strial O'Ciffice
'Public Bldg MHouse/Condo El Ship El Univicollege
[I K-12 School
0 Other
'Asbestos.S
I urveys are'required .
priorlo Renovition and Demolition, however the actual survey is not required to be submitted With the notification.
, SDAPCD:-S,USPART M - Rufe3,61-145 Page-1 of 2
04/2010.
NOTIFICATION OF ASBESTOS RENOVATION OR DEMOLITION WERATIONS
Waste Transporter#l: Waste Transporter#2:
Name! BTS Equipment Unlimited, Inc Naime:-
Address: 13 . 465 Camino Canada # 106-501 Address:
city/statfi/zip: El Cajon/CA/92021 City/St6te/Zip:
Contact Person: Bry.ce Phone: 619-454-580 _7 c ontact Person: Rhone:
Waste Disposal Site (Landfill): Name: EDCO Disposal
Address: 6670'Federal Blvd City/State/Zip:- L~mon.,GfOWICA/01045.
Contact ferson: Lupe Pho.ne. I - 619-287-7555
Asbestos D etection Procedures: Check the appropriate procedures and analyticAl methods used to~'&telct the ~4s6hce of
asbestos containing materials.
Survey [:1 Inspection [__1 TLM P~A
Bulk Sampling El PLM El Other:
Describe work practices and engineering controls to be used.. Check applicable methods below:'
IKI Water 0 Demolition w/roofing materials' in:place,, S + kid Loaders/bo bcats[Tqp 'Loaders-
Amended Water using sledge hammers.~ Term
-
iinator~im'
Roofing Cutting Saws El Axes F-1 ~hovels ImplOsiOri+
High Pressure Water Blast El Demolition w/Cat I Floor1il6s i 9, pl#0
Infrared Machines Ice Chippers El ~ry Bars 0' Negative Air'Machines v
Cranes (wrecking ball, El Bulldozer 0 Ftill Ito
.
ntainment
clamshell, bucket) El Intentional Burning S*Itage Deconl-
El Zamboni El Backhoes C3 ~Glove Bag
0 Bead Blast Other: Fxcavator El' Critic6l.B.6trier's
[3 Floor'Buffer
fo~ Ordered. Demolition provide a copy of the order and complete the intpernati6h below:
Agency Name: Authorizing Person: Title
Date of'Order: Date Ordered to Begin: Phone:
Describe actions to be followed if, unexpected,asbestds is,found during clemolition or
Contingency Plain removal or asbestos material becomes disturbed, ctumbled; pulverized or reduced to
powder.
if unexpected hazardous materials are believed to be found, said work will be stoppFd. BT5,jobsite fbitman will notif~'BTS` offia'-w-he
will then advise the General Contractor of current findings. Hazardous surveywill th~hb&coridtictedby ctrtir1ed.labto,perfdfmed
testing toldentify hazards where a plan for removal will be created if test-resultscome back for haiarddtig materials. p
I certify that an individual trained in;the provisions of this regulation (CFR Part.61, Subpart-M):
Training Certification will be on site during the removal and evidence that the re~uirecl training' has be#n'accomdlishedl
by this peison will.be available for inspedi66.durin'g norrTW buisin6s~s' hours.
Date: 3/28/2017 Print Name:
(Owner/Operator) Ronnie Swaim'jr BTS PM
Signa tuee,
(Ownier/opeiato
information Certification: I certify that the above information is'correct.
Date: 3/28/2017 Print Name:
(Owner/Operator) Ronnie Swaim Jr -BTS PM
Signature!
(QWner/Opera III
'Odginal notificationsare to be submitted to the Districtatleast 10working days priorto r6moval~or.demolition..Revised.nofices are to subrnift6d as
soon as possible but no later than the original start date. Original notifications cannot be7accepted w
. it .
hout the required fee(s) (Rule 4 dfi(s2u, )(2)), however
revised notifications will be accepted without the required fee provided the fee is paid prior to the start date Of the original riotification.
~SDAPdb -SUBPART M - Rule 361.145 Paige 2 of .2
Ud. #76W83
ASE Contracting, Inc.
1985 Friendship Drive, Suite J -El Cajon, CA 92020 (619) 258-7290 - Fax (619) 258-7289
'CERTIFICATE OF COMPLETION
Project Ninie: Ptresidio Pebble Creek Carlsbad
;Prpiect Location: 2200 Afton Way, Carlsbad, CA 92008
Scope of Work., Remove and dispose of asbestos containing floor tile and mastic on
wood per'report by CYA, Asbestos and Lead-Base Paint Survey
dated June 21, 2016.
Proj~ct Start Date: October 25, 2016
Completion Date: October 26, 2016
,.`The~work verformed under this contract has been reviewed and found to be K
substantially complete. All work was done in compliancewith local, state and
fedirallaws applicable to this type of work. Based on a visual* inspection by ASE
i Coniracting, Inc. and Owner's Representative and final. air clearance for re-
occupancy by Envirocheck,'the asbestos containing materials have been removed in
-accordance with the contract. The date of completion is hereby established as
October 26, 2016.
ASE Contracting, Inc.
Authorized Signature: '14'a
Sea,-, Print Name: /'. Algeiue,
Print Title: Z&r.
Owner o~ Owner's Representative:
Authorized Signature:
Print Name: L
Print Title:
'Haa~ar6ous Materials Rehab I Restoration -Asbestos Lead-Based Paints Mold Remediation Demolition
TION ASBESTOS CERTIFICATION DEMOLI
_L_~>ZAb 4~A ADDRESS: Z4>0 6" WAq
USE OF BUILDING TO BE DEMOLISHED: 'SIT-VLF_ VA'ri,,LY Vz.;~_cA0S0e_F_
SQUARE FEET X NUMBER OF STORIES
PROPERTY OWNER: e_AVA_'59AZ) 8, LLC-
;.ADDRESS: Zot G P NAZE~ iS V ri C= r4 off~kTcq P&H 0 N E (6 9 L Z 10Z_
z-Azq X7_r3,01 ~AOPLICANT:
'T" -zr A -'ADDRESS:', 101 L-02b eA_qVq2SPHONE 61'1 ct-49--.31, W.
- - - ------------- - ----- --- - - ----- - ------------- - ----- - - - - - ---------- - ----------- — — - ------------------------- - ---- - ------- - --------------- 777
Section 19827.5 of California Health and Safety Code states in part:
'A demolition permit shall. not be issued by any city ... as to any building or other
structure except upon receipt from the permit applicant of a copy of each written
asbestos notification regarding the building that has been required to be submitted
to the United States Environmental Protection Agency or to a designated state
agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The permit may be issued without the applicant
sdbmifting a copy of the written notification if the applicant declares that the 4-
notification is not applicable to the scheduled demolition project."
---------- - ----------- - - - --------------------------- - - - - - ----------- - - ----- - - - - -------------------- - --------- - - ----- - -------- - ---
As applicant for a demolition permit in the City of Carlsbad, I certify that; I have
read the excerpt from Section 19827.5 of the Health and Safety Code provided
above; the information I have provided on this form is true and correct; and I further
certify t'he.fol lowing:
On the'attached pages are copies of all written asbestos notifications
regarding the above referenced building that are required to be submitted to
the United States Environmental Protection Agency or to Part 61 of Title 40
"-of the Code of Federal Regulations, or successor to that part.
A declare that the written asbestos notification is not applicable to the
-scheduled demolition project.
ApplicarkIs Signature Date
bhA, na ROD BRADLEY, Urban Planner
land planning; -civil -engineering, surveying RONALD L. HOLLOWAY, Civil Engineer,
To: Building Division' Date: September 20, 2016
CITY O,F CARLSBAD W.O.: 983-1326-400 1635 Farada~ Avenue
Carls~ad; CA 92,008 Re: Afton Way
Attention: Demolition Permit
From: Shana 'Crawford
Enclosed 0 Under Separate Cover Please Find:
(1) set of Demolition' Requirements Form B-9
One (1) set of the Building Permit Application
One (1) set of Determination of Project's SWPPP Tier Level and Construction Threat Level Form E-32
One (1) set of Storm Water StandAi'ds Questionnaire Form E-34
One (1) set of the Pro~erty Ov'm- er;iltter
One (1) set of Waste Management Plan Form B-59
One (1), set of the Demolition Asi;esi—os deriffication
One (1) set of theksbest6s and. Lead-Base Paint Survey
F6ur (4) sets of the De'moliiion Plan
~14 THESE ARE TRANSMITTED as chedke~ below: Via: 0 Mail 0 Messenger Hand
0 For your information For approval 0 In accordance with your request
im For Checking'. 0 For your files 0 Please return enclosures
0 Please Sign. o. Please forward o Please telephone me
Please notarize 0 Please record o Please acknowledge with receipt
o Please comment o In accordance with our telephone conversation
Comments:
bhA, Inc.
cc: By: Shana Crawford
Engineering Technician
51 5 Avenida. Encinas, Suite L Carlsbad, California 92008-4387 0 (760) 931-8700 0 FAX (760) 931-7780
SAN DIEGO AIR POLLUTION CONTROL DISTRICT
10124 OLD GROVE ROAD, SAN DIEGO, CA 92131
i,.PHONE (858) 586-2650 FAX (858) 586-2651
FOR APCD USE ONLY
Postmark eceived Fee/ Receipt
Notification # Entered Sector
Inspector Assigned/Date
NOTIFICATION OF ASBESTOS RENOVATION OR DEMOLITION OPERATIONS
Comple~ed by: "RONNIE SWAIM JR Company BTS Equipment Unlimted, Inc.
[:1 Origihal O.Cancellation El Courtesy E] Other(specify):
NOTIFICATION"" FRevision El Change in asbestos amount (2 Cha.nge in start/end date In dicate type of revision) , k (greater than 20%)
KI Demolition El Ordered Demolition Ej Renovation (removal)
YPE Planned Renovation (annual) PROJECT T El Emergency Removal El Emergency Demolition E
FACI LITYINFORMATIO N
Facility Name:
~,Adclress:- .2206 AFTON WAY Cross Street:
-city:, -CARLSBAD Zip Code: 92008
-Facility Owner: PRESIDIO PEBBLE CREEK CARLSBAD 8, LLC (GARY ARNOLD)
Address: -,301 W 28TH, SUITE A
pty: State: Zip Code: NATIONAL CITY CA 91950
contact: -~GARY AR&OLD Title: PRESIDENT Phone No: 619-818-3584
ing Age (years): Number of Floors: Number of Units: 0 59 2
ornmercial El Hospital El Industrial El Office El K-12 School
ublic Bldcl El House/Condo El Ship 0 Univ/College El Other
resent? Will the asbestos be removed? Is the building to be demolished?
CK No El Yes El No IKI Yes El No
Category I Category 11 Total
Pipes: Pipes:
Surface Area: Surface Area:
nent: Facility Component: Facility Component:
Mimollition Operation Start Date: 2/6/2017
Demolition Operation End Date: 3/10/2017
For revisions only
Revised Start Date:
Revised End Date: 3/31/2017
Phone No: CSLB License#:
__7Site City/State/Zip: Supervisor:
e:BTS Equipment Unlimited, Inc I Phone NO: 619-324-7065 CSLB License#: 907777 t
106-501. City/State/Zip: El Cajon/CA/92021 t Site Supervisor: Bryce
*A - sbestos Surveys are required prior to Renovation and Demolition, however the actual survey is not required to be submitted with the notification'
SDAPCD -SUBPART M -Rule 361.145 Page 1 of 2
~,04/2010
Building Size (sq. Tr): Bbild
2082
Building prior/present El C use:
4 P
1 'PROJECT INFORMATION
Asbestos Survey, Is Asbestos P
P&rformed?*
W Yes O'No' El Yes
Friable'
pip s: t e Asll~esr Cis
Amount to be ___ _ I I ~, i §urface Area:
removed
'(sq/In ft): po Facility Co
RevisedAmounts
(if a revision)
Asbestos Remova~ll Start Dat6:.
:Asbestos Removal End Date:
For revisions only)
Revised Start Date:
Revised End Date:
Removall Contractor: N~m~
Ad~r~ss~,', .
Demolition Co tractor: Nam n
Address.- 13465 Camino Canada 4
NOTIFICATION OF ASBESTOS RENOVATION OR DEMOLITION OPERATION S,
Waste Transporter#1: Waste Transporter#2:'
Name: BTS Equipment Unlimited, Inc Nar~e:
Address: 13465 Camino Canada #106-501 Address..
City/State/Zip: El Cajon/CA/92021 Eity/State/Zip:
Contact Person: Bryce Phone: 619-454-5809 Contact Person: hone:
Waste Disposal Site (Landfill): Name: EDCO Disposal
Address: 6670 Federal Blvd city/St6te/Zip: Lemon Grove/CA/91945
Contact Person: Lupe Phone: . 619-287-7555,
Asbestos Detection Procedure! , Check the appropriate procedures and analytical methods used to clete~t the'presence Of 7
a asb( sbestos containing materials. -
* Survey 1:1 Inspection El TEM El PCM
* Bulk Sampling El PLM 0 Other:
Describe work practices and engineering controls to be used. Check applicible methods below:'l
9:1 water El Demolition w/roofing materials in place El Skid Loaders/bobcats/Top Loaders
El Amended Water using sledge hammers. El Terminatorlm
El Roofing Cutting Saws El Axes 0 shovels El Irnplosio
El Demolition w/Cat I Floor tiles in place High Pressure Water Blast I
"
1:1 . Explosi6n
Infrared Machines El Ice Chippers [:1 Pry Bars El Negative Air Machines .
El Cranes (wrecking ball, El Bulldozer El Full Containment
clamshell, bucket) El intentional Burning E] 3 Stage Decon
El Zamboni El Backhoes 0' Glove Bag
El Bead Blast El Other: C.riti'cal Barriers
El Floor Buffer
For Ordered Demolition provide a copy of the order and complete the information below:
Agency Name: Authorizing Person: Title:
Date of Order: Date Ordered to Begin: Phone:
Describe actions to be followed'if unexpected asbestos is found during demolition or-
Contingency Plan removal or asbestos material becomes disturbed, crumbled,' pulverized or reduced to
powder.
If unexpected hazardous materials are believed to be found, said work,will be stopped. BTS'jobsite foreman will notify BTS'office whc
'will then advise the General Contractor of current findings. Hazardous survey will then'be conducted by certified lab to performid
testing to identify hazards where a plan for removal will be created if test results come back positive for hazardous materials.
I certify that an individual trained in the provisions of this regulation (CFR Part 61, Subpa
'
rt M)
Training Certification will be on site during the removal and evidence that the required training has been accomplished
by this person will be available for inspection during normal business hours.
Date: Print Name: Signature: Ronnie Swalmi=
3/7/2017 (Owner/Operator) RONNIE SWAIM JR., (owner/Operator) ir
Information Certification: I certify that the above information is correct.
Date: Print Name: Signature.. Ronnie - .1 3/7/2017 (owner/operator) RONNIE SWAIM JR (Owner/ope rator) Swaim ir
Original notifications are to be submitted to the District at least 10 working days prior to removal or demolition. Revised-notices are to be submitted as,
soon as possible but no later than the original start date. Original notifications cannot be accepted without the required fee(s) (Rule 40(f)(2)), however
revised notifications will be accepted without the required fee provided the fee is paid p riorto the start date of the original notification.
SDAPCD -SUBPART M - Rule 361.145 Page 2 of 2
Shay Even MOD
Fiom: Amber Ressmer
Sent:, Wednesday, October 12, 2016 10:33 AM
To: gary@pebblecreekcompanies.com
Cc:. Building
Subject: CB163719 Demolition plan does not require Fire Dept. fire plan review
Good morning Gary,
v '~c 6 are receiving this email because you are the applicant on the permit #CB163719 'Demolition for 2200 Afton Way' in
Carlsbad, CA. The fire marshal has determined ihat the fire department does not need to review these plans and no fire
inspection is necessary.,
you,,
Amber
Y
, OF",
ad
~,Arnber Ressm~r
'Administrative Assistant
re Prevention
City of Carlsbad
"'1635 Faraday Ave.
tarlsb`a'd, CA 92008-7314
!www.carlsbadca.gov
:,P-760:-602-4665 -602-8561 760
A
-t%
-Asbest6s and Le~d-Based Paint Survey
2200 Afton Way Carlsbad, CA
June 21, 2016 %
'OF CONTENTS TABLE
E`XECUTIVE SUMMARY.'
1.0 ,ZACKGROUND
.,2.0 SURVEY PROCEDURES
SURVEY RESULTS .3'0
4.0 .'.,RECOMMENDATIONS
LIMITATIONS AND DISCLAIMER
~'.REFERENCE 1 .-CURRENT REGULATIONS
APPE N~'DIX A 7ASBESTOS CHAIN OF CUSTODY AND BULK SAWLE LOG
APPENDIX B BULK ASBESTOS ANALYSIS REPORT
APPENDIXC SITE DRAWINGS
ro
, Nl,
" Asbes'tos and Lead-Based Paint Survey
2200 Afton Way, Carlsbad, CA
June 21,2016
L
-EXECUTIVE SUNINL4,RY
A 'YA) was retained to perform an asbestos building material and 4Z c Young ~sociatels (C A
lead-based Painted building component survey for the structure located at 2200 Afton
Way in Carlsbad, California. The survey was conducted on June 8, 2016 by ~&. John
Payne "a Cal.ifon-da Certified Asbestos Consultant #93-1226, a U.S. EPA certified
building inspector and a CDPHS #25387 Certified Lead Sampling Technician.
,taI56ratory analysis - revealed detectable levels of asbestos or assumed asbestos in the
f6ll6w buildin materials: ~g g v
e 9X9 Vi~iyl Floor Tile-Throughout second floor of the structure
XRFR~adings did not reveal detectable levels of lead in the painted components of the
s ti-u iu. c re.-
J.,
Locations and conditions of building materials or components assessed and sampled
-t'canbefo~~din_SectionI*.
av
7
r
Asbestos and Lead-Based Paint Survey
9700 Afton Way, Carlsbad, CA
June 21, 2016
1.0 BACKGROUND
Asbestos
-The term "asbestos" applies to six naturally occurring mineral fibers that have been used
for an abundance of commercial purposes over the years. These fibers belong to two
separate mineral groups, known as serpentine and amphibole. The serpentine group,
usually of a curly. form, contains only one asbestiform variety, referred to as chrysotile.
The amphibole. group, which is straight and needle-like, contains five asbestiform
varieties: anthophyllite, grunerite (amosite), riebeckite (crocidolite), tremolite, and
-is were used in commercial products, chrysotile is the actinolite. While all of these forn
form most ~ommonly found.
Asbestos is considered hazardous to humans only if the fibers become airborne and are
inhaled, as they can become imbedded in the lung and a potential catalyst to disease.
-Existing data suggests that the risk of such disease, including lung
cancer, mesotheliorna and nonmalignant lung and pleural disorders (i.e., asbestosis,
pleural plaques, pleural thickening, and pleural effusions), is only remarkable if
11significant" exposure to asbestos occurs. In consideration of these understandings,
health management objectives for asbestos containing materials (ACMs) are to keep
them bound in a matrix and/or prevent any asbestos fibers from becoming airborne.
According to the EPA, "ACM" is defined as material containing more than one percent
asbestos by volume and a "regulated asbestos containing material (RACM)" is
defined as material containing more than one tenth percent (>0.1%) asbestos. Further,
ACMs and RACMs are classified as either friable or non-friable. "Friable" ACM is any
material that meets the ACM definition above, depending on whether it is a bulk or
sheet material, and can be crumbled, pulverized, or reduced to powder by the pressure
-of an ordinary human hand. "Non-friable" ACM is any material that meets the ACM
definition above, but cannot be pulverized under hand pressure. It should be noted that
"non-friable" ACMs can become "friable" if their base matrix (e.g., a vinyl floor tile,
finished wall board/joint compound) deteriorates by normal wear and tear or if they
have be6n subjected to sanding, grinding, cutting, or abrading.
Lead-Based Paint
Federal standards define lead~based paint (LBP) as any paint with a lead content equal
to or greater than 0.5% or 5000 parts per million (ppm) or 1 milligram per square
centimeter (mg/cn~2). Other jurisdictions can be more conservative, e.g., the San Diego
2
-Asbestos and Lead-Based Paint Survey, -.2200 Afton Way, Carlsbad, CA
June 21, 2016
tnvironmental Services Department defines LBP as paint with a lead content equal to
or great6r than 0.5 mg/cm~ or 1000 ppm. Cal-OSHA recognizes the federal standard,
but requires that all workers be properly protected when working with materials
containing any level of lead in -accordance with CCR Title 8 Section 1532.1.
It is Widely recognized that structures built before 1978 are likely to contain LBP. If not
managed properly, the lead can pose health hazards to building occupants (especially
young children) and construction workers, alike.
ings summarized below are presented in regard to the above-referenced .4he find
:.,'definitions,and factors.
3
Asbestos and Lead-Based Paint Survey
2206Afton Way, Carlsbad, CA
June ~1, 2016
2.0 SURVEY PROCEDURtS
Puipose and Approach
The purpose of the survey was to locate and identify interior and exterior suspect
building materials and components for the presence of ACM and LBP. The survey
.incRided a visual inspection of building materials comprising the onsite structure, the
acquisition and analysis of bulk samples from suspect and homogenous building
material for detectable levels of asbestos, and X-Ray Fluorescence (XRF) analysis of
~uspect and homogeneous painted building components for lead content.
"Homogeneous" building materials are defined as building materials that are uniform
in texture, construction or application date and general appearance. Relative to the bulk
samples for asbestos analysis, they are further classified as Surfacing materials, Thermal
Syptem Insulation (TSI) and/or miscellaneous materials with notations regarding their
friability'and condition.
All ac~essible interior and exterior features of the onsite structure were visually
ms ected.7 Any building materials not identified in this report may be present within P
~hidden and/or concealed areas.
Asbestos
Each
i
suspect ACM identified during the visual survey was sampled in accordance with
the EPA's established guidelines document, "Guidance for Controlling Asbestos-
Containing Materials in Buildings" (EPA 560/5-85-024,1985) and 40 CFR Part 763.86
~_f'Asbestos_Coiitaining Materials in Schools, Final Rule" (AHERA), as follows:
Building materials were categorized on the basis of their homogeneity; i.e.,
uniformity in texture, construction or application date and general appearance.
Each building material was also categorized as either "friable" and "non-friable,-
as defined above.
A random sampling scheme was developed based upon the location and
quantities of the various homogeneous building materials. The number of
samples obtained, for each identified friable homogeneous area was based upon
the overall square footage of material, as indicated below:
Size of Sampling Area Number of Samples Collected
Less Than 1,000 sq. ft. 3 - Samples
Between 1,000 & 5,000 sq. ft. 5 - Samples
,Greater than 5,000 sq. Ft. ~7 - Samples
'As~estos and Lead-Based Paint Survey
2200 Afton Way, Carlsbad, CA
June 21, 2016
*The re
'
commended number of samples per AHERA is nine for areas greater than 5,000 square
feet; or at least one additional sample per additional 1,000 square feet.
Bulk samples were collected by extracting a representative portion of each
-selected building material, placing the selected building material into a sampling
A; container, and assigning a unique sample number to each sample. The samples
_~v~re then placed into a sealed shipping container for delivery to an accredited
.-Jaboratory., Sampling equipment was decontaminated between samples to
prevent the cross- contamination.
!_-Each ,bulk sample was recorded on a bulk sample log and possession of the
samples was tracked by a chain-of-custody record.
Each. bulk sample ~vas analyzed by Polarized Light Microscopy (PLM) in
accordance with the,"Interim Method for the Determination of Asbestos in Bulk
Insulation Samples EPA - 600/R-93-116 dated December 1982 and adopted by
the National Voluntary Laboratory Accreditation Program (NVLAP) Title 15,
part 7 of the Code of Federal Register as affiliated with the National Institute for
st'andards and Testing (NIST) and USEPA 40 CFR Part 763.87. The reported
asbestos results in this report are a visual estimate by area of asbestos
concentration. Results for heterogeneous samples examined by component are
reported as a composite. The lower limit of reliable detection for this method is
.1%. - S
,
amples containing asbestos in a concentration lower than the limit of
r zliable detection (<%) are reported as "Trace." L
Lead-Base:d Paint.*
The LBP survey was similarly conducted by identifying homogeneous painted building
components (ceramictile, loose and flanking paint, etc.) for lead content, entering each
functional and identifiable space (i.e., room equivalent), such as a room, hallway,
staircase, foyer and exterior, testing the component with a hand-held XRF LBP analyzer,
ir~ noting the location and condition of the component/ paint. Sides in a room-
eq,4ivalent indicate sample locations, with side A representing the wall where the
p~imary entry door is located and sides B, C & D representing each respective wall in a
cloc' kwise direction.
All data, findings and recommendations presented in this report are based on the
inf6rmation(assessment' and readings) obtained by our inspector during the survey.
5
V
Asbestos a~d Lead-Based Paint Survey
2200 Afton Way, Carlsbad, tA
June 21, 2016
3.0- SURVEY RESULTS
'~,sbestos
The f~llow` ing 1 s- a'summary of each building material tested for asbestos and its
respective laboratory result:
Material Sample Asbestos Location of Material ACM? Friable? Damaged?
Number Content
9x9 Vinyl Floor 1,2,3,4, Tile-2-3% Throughout Second Yes No No
Tile and Mastic -5 Chrysotile Floor
Black Mastic-3%
Chrysotile
Tan Mastic-ND
Roofing Felt 6 ND Throughout Roof No N/ A N/A
Roof Mastic ~7 ND Throughout Roof No N/ A N/A
ND=Not Detected N/A=Not Applicable
Leaa-Based Paint
Tl~e iollowing is a summary of each building component tested for lead and its
respestive XRF result:
Location, Sample
Number
Side Component Substrate Pb
mg/CM2
Condition
Calibration 1.0
~..Calibration 1.0
Calibrafion 1.0
Exterior 1 A Wall Wood 0.0 N/A
-Exterior 2 B Wall Wood 0.0 N/A
Exterior., 3 A Door Wood 0.0 N/A
Exterior 4 A Door jamb Wood 0.0 N/A
Exterior 5 A Eave Wood 0.0 N/A
Exterior 6 A Fascia Wood 0.0 N/A
Interior 7 B Wall Wood 0.0 N/A
Interior 8 C Wall Wood 0.0 N/A
"Interior 9 A Door Jamb Wood 0.0 N/A
Interior 10 A Door Wood 0.0 N/A
Interior 11 A Shower Ceramic
Tile
TO N/A
Interior 12 Floor Ceramic
Tile
0.0 N/A
Pb mg/cm2=mil-ligrams of lead per square centimeter of surface area N/A=Not Applicable
,7! 6
,~sb~stos'and Lead-Bas~d Paint Survey
2200 Afton Way, Carlsbad, CA,.
1jdne21,2016
4.0,.~, RECOMMENDATIONS
ACM - Current federal, state and local (i.e., Air Pollution Control District, or APCD)
regulations require that if, during any renovation or demolition activities, asbestos-
~.-cbritaining building materials will be disturbed, only contractors who have been
properly trained and licensed in the correct handling of ACM can conduct any repair,
removal ~nd/ or demolition -activities. All environmental work should proceed under
the " dance or direction of an independent State Certified Asbestos Consultant (e.g., gui.
CAC)~_
LBP.Comp6n Nof Applicable ents.
-7
C
% P
7
Asbestos and Lead-Based Paint Survey
2200 Afton Way-Carlsbad, CA
June 21, 2016
—LIMITATIONS and DISCLAIMER
The recommendations in this report are professional opinions based solely on visual
observations and analytical analyses, as described in this report. Any opinions or
-anen recon. dAtions presented herein apply to site conditions existing at the time of our
mvestigation and cannot necessarily apply to site changes of which CYA is not aware of
-
and/or has not had the opportunity to evaluate.
The findings and recommendations contained in this report are reflective of currently
accepte,d standards and practices applicable to this location and are subject to the
followin inherent limitations: 9,
The data and findin presented in fi-ds report we valid as of the date when the gs
survey was performed. The passage of time, manifestation of latent conditions or
occurrence of future events may require further exploration at the site, analysis of
the data, and reevaluation of the findings, observations, and conclusions expressed
in-th6 report.
.The data reported and the findings, observations, and conclusions expressed in the
report are limited by the Scope of Work presented.
Unless otherwise stated in the report, because of the limitations stated above, the
findings observations, and conclusions expressed by CYA in this report are not, and
should not be, considered an opinion concerning the compliance of any past or
p resent owner or operator of the site with any federal, state or local law or
regulation.
No warrai6ty or guarantee, express or implied, is made with respect to the data or
& reported findings, observations, and conclusions, all of which, however,
accurately reflect site conditions in existence at the time of investigation.
CYA reports present professional opinions and findings of a scientific and technical
nature. While attempts were made to relate the data and findings to applicable
environmental laws and regulations, the report shall not be construed to offer legal
opinion as to the requirements of, nor compliance with, environmental laws, rules,
regulations or policies of federal, state or local governmental agencies. Any use
constitutes acceptance of the lirnits of CYA's liability. CYXs liability extends only to
those parties contracted to complete this project and not to any other parties who
may obtain the Report. Legal issues raised by the report should be reviewed by
appropriate legal counsel.
8
1 4
Asbestos and Lead-Based Paint Survey'
2200 Afton Way, Carlsbad, CA
June 21, 2016
REFERENCE 1
CURRENT REGULATIONS
4.;
The. following is a summary of current state and federal regulations that contain
..,requirements related to the performance of building surveys for asbestos. These
summaries are not intended to be all inclusive and do not contain every aspect of the
r&gulations discussed. Regulatio n-s pertaining to the removal and disposal of ACMs are
not included.,,,
NE19HAP
Under the National Emission Standard for Hazardous Air Pollutants (NESHAP), 40
CFR Part 61, regulation, no visible emissions are allowed during building demolition
or renovation activities which involve regulated asbestos-containing materials
(RACMs). For this reason, all buildings must be surveyed for ACMs prior to
demolition or renovation. The EPA and/or the local air quality management district
that implements EPA actions must be notified prior to any building demolition even
if no ACMs are present. RACM is defined as any material with an asbestos content of
greater than one percent and is friable, or Category I non-friable ACM that has or
wiH beco,me friable, or Category II non-friable ACM that may become or will become A
crumbled, pulverized, or reduced to powder by the forces expected to act on the
material in the course of demolition or renovation.
According to NESHAP, is material containing more than one percent asbestos
as determined using the methods specified in Appendix A, Subpart E, 40 CFR Part
.763, Section 1, PLM. The NESHAP classifies ACM as friable or non-friable. Friable
ACM_ is ACM that contains more than one percent asbestos and when dry, can be
'crumbled, pulverized, or reduced to powder by hand pressure.
Non-fridble ACM also contains more than one percent asbestos and is further
classified as either Category I ACM or Category II ACM. The materials are
distinguished by their potential to release fibers when damaged. Category II ACMs
are much more likely to release fibers when damaged. Category I ACM includes
asbestog-containing gaskets, packings, resilient floor coverings and mastics, and
asphalt roofing products. Asphalt roofing products are those products that contain
and include built-up roofing, asphalt-containing single ply membrane asbestos
systems, asphalt shingles, asphalt-containing underlayment felts, asphalt-containing
ro6f coatin and mastics, and asphalt-containing base flashings. Category II ACM gs
includds all other non-friable ACM; for example: asbestos cement shingles, asbestos
-cement tiles, and Transite boards or panels.
9
'A;best o-s' and Lead-Based . Paint Survey
2200 Afton Way, Carlsbad, CA
2016 June 21
San Diego Air Pollution Control District
Jhe San Diego Air Pollution Control District (SDAPCD) is a government agency that
-dn San Diego County to protect public health. ~egulates sources of air pollution witl
The District's regulating and enforcement authority comes from state law and, in
certain cases, federal law. In response to the NESHAP requirements, SDAPCD
Implemented Rule 351.145 that pertains to demolition/ renovation activities
including the removal and associated disturbance of ACMs. These requirements for
demolition and renovation activities include notification, ACM removal procedures,
time schedules, ACM handling and cleanup procedures, storage, disposal, and
'landfill requirements for asbestos-containing waste materials. Rule 351.145 is
applicable to owners and operators of any demolition or renovation activity and
associated disturbance of ACMs. Failure to comply with Rule 351.145 requirements
could result in violations that carry daily penalties (penalties assessment is based
upon the size of the project and severity of noncompliance).
~A~HERA
AHERA requires performance of asbestos surveys and the development of Asbestos
Management Plans for all of the nation's primary and secondary schools. The general
procedures mandated under AHERA are considered the industry standard and are
used as guidelines for all surveys performed by CYA.
California Occupational Safety and Health Administration (Cal-OSHA)
Per Cal-OSILk st'andards 1926.1101, ACMs are defined as any materials with an
asbestos content greater than one-tenth of one percent (>0.1 %) and are further
j'dassified as Class I, Class H Class III or Class IV ACM. The materials are
'distinguished by their potential to release fibers when damaged. OSHA prescribes
-specific engineering controls and work practices for each Class of Ac. M.
Class I-This Class refers to ACMs identified as Thermal System Insulation (TSI)
or surfacing (sprayed-on or troweled-on) materials. These materials are
g~nerally considered friable.
Class II-This Class refers to ACMs identified that are not Thermal System
(TSI) or surfacing materials. These materials are generally considered
non-friable.
Class III-This Class refers to repair and maintenance operations of all identified
ACMs.
10
Asbestos ~nd Lead-Based Paint Survey
2200 Afton Way, Carlsbad, CA
June'21, 2016
Class IV-This Class refers to incidental contact with identified ACMs such as
..~ustodial staff.
..tiliforpia Health and Safety Code
The California Health and Safety Code 25915 (former Connelly Bill) requires an
building owners
-
in the State of California to provide -written notification to
emplo yees, tenants, and contractors of the presence and location of asbestos-
containing construction materials (ACCMs) within their buildings. Some exclusions
to 6e notification rule for restricted access areas are allowed. All documentation
related to asbestos surveys (and air monitoring) must be made available to
em loyees, tenants, or contractors for review. ACCMs are defined as any materials I p
-with an asbestos content greater than one-tenth of one percent (>O.l
The California Health and Safety Code also require that a seller with any knowledge
bf ACMs on a property disclose such information or knowledge to other parties
inV61ved in a real estate transaction.
Asbe'st'os Rem'oval and Building DemolitioxVRenovation
ida~cordance with the EPA's NESHAPs regulation and the SDAPCD, all facilities
planned for renovation or demolition must be surveyed for ACMs prior to the
~planned renovation or demolition. Subsequent removal of identified ACMs is also
required. Removal involves, to the greatest extent practical, the complete removal,
disposal, and replacement, if necessary, of the asbestos-containing building material
'-(ACBM)..Removal usually also requires encapsulation of the remaining structure to
-.,.,,lock down residual fibers which may exist. Removal of ACMs is required prior to
renovation and/or dem olition activities.
-,The EPA'and AQNM require removal of all ACMs prior to demolition or renovation.
ACMs include friable ACMs, (Class I) which have or will become friable or that has
been subjected to sanding, drilling, grinding, cutting, or abrading; and Class II ACMs
that miay become or, has become crumbled, pulverized, or reduced to powder by the
forces expe~ted to act on the material in the course of demolition or renovation.
Trace ACMs are asbestos materials with less than 1 percent, but greater that 0.1
percent asbestos. These ACMs require an abatement plan during demolition that is
.protective of worker health and safety. However, unlike an EPA ACM, trace ACMs
-,d'o not necessitate special disposal requirements.
t
APPENDIX A
ASBESTOS CHAIN OF CUSTODY
AND BULK SAMPLE LOG
4
AMBIENT ENVIRONMENTAL, INC.
Asbestos Lead Field Services 1464 6TJ) STREET 0.
NORCO. CALIFORNIA 92860 Indoor Air Quality Services
* TEL: (951) 272-4-730
j
Phase I Site Assmments
* FAX: (951) 2724731 Lab Services
ASBESTOS BULK SAMPLE LOG Pap of
,Client Namet'a.
Z Ain, Prqj~ct Location: c2~
b a te": .—Field Technician, Djk'& f
3-5 Days Project Nutfiber- Priority: ASAP 24 HR
SAMPLE SAMPLE LOCATION MATERIAL DESCRIPTION SQUARE NUMBER.
FOOTAGE
'1:;";oot
AAX-
0, x
A4rl,
Chaii of Cu'stody, ethod: PLM: ~OTEM: Other:
Sampled By Date Time wRelliquished By Date Time f Received By fl~~ Date Time Relinquished By
Received
Date Time By Date I Time
AL `8~ r--rensic Analytical Final Report
R I E S
Bulk Asbestos Analysis
(EPA Method 600/R-93-116, Visual Area Estimation)
Ambient Enviro nmental Inc Client ED: 5697
John Payne,,, Report Number: B222813
1464 6th Street Date Received: 06/09/16
Date Analyzed: 06/10/16
Norco, CA 92860 Date Printed: 06/10/16
First Reported: 06/10/16
Job ED/Site: 16-1391; 2200 Afton Way FALI Job ED: 5697
Total Samples Submitted: 7
Date(s) Collected: 06/08/2016 Total Samples Analyzed: 7
Asbestos Percentin Asbestos Percentin Asbestos Percentin
Sample ID Lab Number Type Layer Type Layer Type Layer
01 50995254
Uye-r: Brown Tile Chrysotile 2%
Layer: Tan Mastic ND
Layer: Black Felt" ND
Total Compo~site Values OfFibrous Componefits:' Asbestos (2%),
Cellulose (5,%) Synthetic (Trace)
02-50995255~
'.Layer: Brown Tile Chrysotile 2%
Laje r: tan Mastic ND
Layer: Black Felt ND
Total Composite Valuei of Fibrous Components: Asbestos (20/o)..
61lulose (5 %) 'Synthetic-(Trace~
03. 50995256
Layer Brown Tile Chrysotile 2%
Layer: Tan Mastic ND
Layer: Black Felt ND
Total Corr~posite Values of Fibrous CoMpop6rits: :-.'.Asbest6s'(2X)
- Cellulose (5 %) Synth6fic-(Trace)-'
04 50995257
Layer: Tan Tile
Layer: Bl'ack, Mastic
Chrysotile 3%
Cbrysotile 3%
'Layer: Black Felt. ND
Total Composite Va lues of Fibrous Comp6nen ts* Asbestos
Cellulose (5 %)' Synthetic (Trace)
'05 50995258
Layer: Off-White Tar Chrysotile 3%
Layer: Black Mastic Chrysotile 3%
Layer: Black Felt ND
Total Composite Values of Fibious ComP6n ents' Asbestos
Cellulose (5 %) Synthetic (Trace) -
06 50995259
~ayer: Grey Roof Shingle ND
Total Composite Values of Fibfou: s Components:.',-:: Asbestos.(N.D) . .... .. :
Cellul&e (Trace) fibrous Gla ss: 5
2959 Pacific Commerce Drive, Rancho Dominguez, I of 2
CA 90221 Telephone: (310) 763-2374 (888) 813-9417 Fax: (310) 763-8684
Report Nwnber: B222813
2Client Naine-*-A'mbient Environmental Inc Date Printed: 06/10/16
Asbestos Percent in Asbestos Percentin Asbestos Percentin
§am`pl6 ID Lab Number Type Layer Type Layer Type Layer
'67 50995260
Uyer: Black Semi-FibrousTiir ND
-Total Composite Values of Fibrous Components: Asbesto§,(ND)
0 ~O)i 61lulose 0'
4
Tiffani Ludd, Laboratory Supervisor, Rancho Dominguez Laboratory
'Note: Limit of Quantification ('LOQ') =I%. 'Trace' denotes the presence of asbestos below the LOQ. 'ND'= 'None Detected'.
Analytical risults and reports are generated by Forensic Analylical Uboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such
report. Results:reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s) tested.
-
Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALL The client is solely responsible for the use and interpretation of test results and report,, requested from FALL Forensic Analytical Laboratories Inc. is not able to assess the degree of hazard resulting from materials
an~lyzed. FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. All samples were
receiyed in acceptable condition unims otherwise n6ted.
2 of 2 2959 Pacifil Commerce Drive, Rancho Dominguez, CA 90221 Telephone: (310) 76'3-2374 (888) 813-9417 Fax: (310) 763-8684
c
APPENDIX C
SITE DRAWINGS
04
BR
05
0
IN
[as
F
-SITE DRAWING
ROOF 06 07
LWING ROOM
RR
IGTCHEN
RR
01
02 03
SECOND FLOOR
ir
GARAGE
4'.. FIRST FLOOR
"SITE"LOCATIO 2200 AFTON WAY N
CA -CARLSBAD,
Development Services
Ci 6f WASTE MANAGEMENT Bulding Division .."17 -ty PLAN 1635 Farad
i
ay Avenue
Ccirlsbad 760-602-2719
B-59 www.carisbadca.gov
Presidio Pebble Creek Carsibad 8, LLC Contractor: Pebble Creek Companies
Ownerii.-
2200 Afton Way 619-938-0312
Job Address: Phone Number
Per mk#: Estimated Cost of Project $
Typ~ bf PrDJ e= New Construction []RemodelorT.I. DResidential Commercial IRDemolition
(check all that apply) [3 Other
N
I on-hazardous construction waste generated duringthe course ofthis projectshall be recycled and/or salvaged for re-use at a
minimum of 50% per CALGreen Sec. 5.408.L Failure to comply'may result in a penalty fee up to $1,000. For projects which
consist of mainly equipment and/or racking, that have a combined weight of-new construction disposal that does not exceed 2
meet. e 50% minimum requireimerit po, lbs per square foot of building area affected by this permit, may be deemed to th u n
approval of Building Deprtment,
-ALTERNATIVE FORMS OF COMPLIANCE: (if selected, do not complete Tables 1& 2 below)
~b cons'tru6tion waste shall not exceed 2 lbs. per sf. of area. All receipts shall be provided to the Building Official prior to
final. (This option nat.applicable for most construction projects.)
. I X 2 lbs. lbs. of allowabfe-waste. Square feet of construction area-
I plan on using a WASTE MANAGEMENT roll-off bin. Ali receipts shall be provided to the Building Official prior to final.
Table I - Estimated V%ste (To be filled but priorto permit issuance - refer to example on Page 2.)
V
MATERIALS lbs. of waste to be taken to
LANDFILL
lbr~ of waste to be
RE4 . BEI) or RECYCLED Waste HaulingCompany or Re4ise Method
Asphalt/ Concrete 7 _5
Brick / Masonry
Cardboard
Drywall
Landscape Debris
Lumber/Wood
Metals,
Mixed Waste
Trash Ga ge
other
TOTAL Ibm.
-U Eslirnate~ Percentage to be Re sed or Recycled-%
Icertifythatthe information provided herein, to the. best of mylknowledge, Istrueand correct.
01
contrac"Owner(prInIp
Official Use Only
0 Plan Denied [1 Project Valuation Approved 0 Plan Approved
Reviewed/ App6oved by:!,
Page I of 2
47,