HomeMy WebLinkAbout2221 LAS PALMAS DR; C; CB983998; Permitf I''. • l
I ' · City of Carlsbad
01/14/1999 Building Permit Permit No:CB983998
-·-
Building Inspection Request Line (760) 438-3101
Job Address:
Permit Type:
Parcel No:-...
Valuation:
,,,
• 2221 LAS PALMAS DR CBAD St: C
"' ITI . Sub Type:
i130503100 Lot#:
$103,600.00 Construction Type: NEW
Occupancy Group: Reference #:
__ Project Title:
Applicant:
3700 SF TI-WALLS,CEIL,MECH,ELC
PLUMB-TERMiNIX
Owner:
Status:
Applied:
Entered By:
Appr/lssued:
Inspect Area:
BARBARA WHARTON
639 BISON CT
GILDRED DEVELOPMENT CO
ISSUED
11/19/1998
RMA
01/14/1999
EL CAJON CA 92019 92019
619 203-1773
5346 01/14/99 0001 01. 02
C-PRMT 747n64
Total Fees: $1,160.64 Total Payments To Date: $413.00 Balance Due: $747.64
Description Fee
* ELECTRICAL TOTAL 40. 00
* MECHANICAL TOTAL 24.00
* PLUMBING TOTAL 27.00
BLDG P~AN CHECK 412.80
BUILDING PMTS 635.08
STRNG MOTION 21.76
Inspector:
FINAL APPROVAL
Date: «,,,--3~ f:J' Clearance:
NOTICE: Please take NOTICE that approval of-your projecUncludes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." 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 procec;fures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code·Section 3.3~.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other. similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have oreviouslv been oiven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otheiwise exoired.
City of Carlsbad
03/29/1999 Building Permit Permit No:CB983998
Building Inspection Request Line (760) 438-3101
Job Address:
,Permit Type:
'Parcel No:~
Valuation:
" 2221 LAS PALMAS DR CBAD St: C
~ ITI Sub Type:
2130503100 Lot#:
$103,600.00 Construction Type: NEW
Occupancy Group: Reference #:
Project Title:
Applicant:
3100 SF TI-WALLS,CEIL,MECH,ELC
PLUMB-TERMINIX
Owner:
Status:
Applied:
Entered By:
Appr/lssued:
Inspect Area:
ISSUED
11/19/1998
RMA
01/14/1999
RB
BARBARA WHARTON GtLQ8ED DEVELOPMENT (jf,88 03/'J!J/99 0001 01 ~ C--ffit!T 639 BISON CT 92019
619 203-1773
Total Fees:
Inspector:
I <fffi_ ~~0'~~~\
FINAL APPROVAL
$30.00
Fee
40.00
24.00
27.00
412.80
635.08
30.00
21. 76
Date: _____ _ Clearance: _____ _
NOTICE: Please take NOTICE that approval of your project includes the ~Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions.' You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the prote&t procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exactions of which vou have oreviously been oiven a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otheiwise exoired.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161
02
30-00
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161·
Name
~1§J>.$l!iAQ;'TQ~'i)_;pi~~f~1f,'{&M~
Cl{lt2108
FOR OFFICE USE O. Y
'State License # -~~-=-------'
(!),;'. ::YV_9_~!{E.@~;~ 1?~~$'A;f'IO~' -~---~-.:,::~7--:~-;~. ----2_;\;::',:;;:•,"-:;;,Sv~:7"'~,:~JG;:';~:.s;·,:,.'.'.:,>.',,
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
02
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, ,for the performance .
of the wo for which this permit is issued.
I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which'lh'femit is
.issued. My worker's co ~s i insura rrier .and policy number are: if I ,J z 'd 12"
Insurance Company : Policy No.[¥ i{(J{2t{-l-3 {_3 . Expiration Date _ _,_~~--7_,_L __
(THIS SECTION NEED NOT BE COMPLETED I E PERMIT IS FOR ONE HUNDRED-DOLLARS [$.100] OR LESS)·
0 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 become subject to the Wqrkers' Compensation Laws of California. · · · · ··
,· WARNING: Failure to secure work s' compensation coverage is unlawful, aiu;I shall subject ail, employer to criminal penaltie , a~d civil fines up to one hundred
_thousand dollars ($100,000), in • ost of compensation, damages as provided for in Section 3706 of the La',-}c e, inte st ~j-attorney's fees.
SIGNATURE . . DATE_-~/~ 1....._,,_~-=y-
tC,,_.OWNER~ii.Yl,tDEifDECbARATJON0 ,, __ ,_,, __ , ------· 0 • •• _-·:; ;,,_f', '."' '' ·,:'
I hereby affirm that I am exempt from the Contractor's License Law for the following. reason:
0 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 Contract_or's License Law does hot apply·to an owner of property who builds or improves ther.eon, 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).
D 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 a.n owner of property who builds or improves thereon, and contracts for such projects· with contractor(s) licensed
pursuant to the Contractor's License Law).
0 I am exempt under Section --+-----Business and Professions Code for this reason:
1. I personally plan to provide the ajar labor and materials for construction of the propo,i;ed property improvement. D YES D NO
2. a building permit for the proposed work.
3. I have contracted with the folio rson (firm) to provide the proposed. construction (include name. / address / phone number / contractors license number):
4. I plan to provide portions of the k, but I have hired the following perscin·to coordinate, supervise and provide the major work (include name/ address / phone
number/ contractors license number),: -t--------------..,......,,...-,,, ____ _,. ______________ .,.,....,_.,.,... ______ _
·5. I will provide some of the war , bu I have contracted (hired) the following persons to provide the work indicated (include name / add(ess / phone number / type of work): ________________________________________________________ _
,PROPERTY OWNER SIGNATURE ____________ ~~---~~--~ DATE_~-------
(cQIY[fLE;TE 'IHIS.SECTION FO)rl(ON-RESIDENTIAL 'BPltDING ,PERMlil"SJ)NLY;;;:;.'" < -· _ ' · • > ~--' ~·-· · -~;;, .:_->-;L' .. 2.c;.>:,_-:'.' (.:. ·
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-Tanner Hazardous-Substance Account Act? D YES O NO
Is the applicant or future building occupant required to obtain a permit from the air. pollution control district or air quality management district? D YES D NO
Is the facility to·be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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.
~....:.r<tONS:T8U,&TIOJll;E~DlNG:·AG~N Y ·_:,.,_<,;, · · ·;-~ ~ __ ,.:· ·.::..:,,__'.-~1-: .~--.":';''..:.:., -.,.·: _·. ·;._:,;~-c; 7~--. _
I hereby affirm that there.is a con tru ion lending agency for the performance of the-,work for which this permit is issued (Sec. ;3097(i) Civif Code).
LENDER'S NAME LENDER'S ADDRESS
f9.r :-:APPI/ICANT~CAJ!O~:·-::,: •·:::-. . .-:.:. .... ·. . -·.-... · _:,;_r..,:.::-,0· -:,".'".·-'7,::::;. ,,::::,:::,_:;:_ .... ::: .. = .... ::: .. :: .. = _ _.=. =_= .. :::,.<;;·:>;::;,_;:::,,::::~;:, .==,);;::".';:~:::_ =,=. ::::: __ ._;; .. _:::.,.;:.-!:;:_-r::;:::::-;::;;;;::;::::::;:;::::::::::::;;;::::::;:.,
I 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 representatives of the Cit\' of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND 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.
work authorized by such permit is n
or abandoned at any time after th
APPLICANT'S SIGNATURE -L.,~~m:;'1;;£'.__.,a,:-L.$;~~~'.JJ'..,_ _______ _
· WHITE: File YELLOW: Applicant PINK: Finance
FROM: FAX NO. 6192734141 Sep. 05 1998 03:55PM Pi
~:, INTER·ARCH a!.81 SPACE PLANNING • INTERIOR DESIGN
FAX-MEMO
TO:
CARLSBAD BUILSDING DEPARMENT
ATTENTION: FAX# (619)
PROJECT: TERMINIX PLAN FILE# C8983998
FROM: PENNE HORN FAX# (619)273-4141
DATE: Thursday, January 07, 1999 9:12 AM
THERE IS 1 PAGE TO THIS DOCUMENT INCLUDING THIS COVER PAGE.
PURPOSE: D For approval D As requested D For your use D Preliminary D For review D Information · D F Or bid-Due date
REMARKS:
D Action required D For your records D Approved D For engineering D Disapproved D Permit processing D Correct and resubmit
We have been asked to submit a square footage table indicating what is new
construction and what is existing.
This is a remodel of existing office an.d warehouse space. We presently have
3,700 useable square feet of existing office area in suites C & D. We are
remodeling approximately 1, 126 square feet of that office area.
We presently have 3,800 of ware house area. We are not remodeling any of
this area, other than adding a chain link fence and curb.
INTER•ARCH INC. •4141 JUiLAND DRIVE SUITE: 320 • SAN DIEGO• CALIFORNIA 92117
(619) 273-9090 • ~AX (619) 273-4141
City of Carlsbad Inspection Request
For: 4/22/99
Permit# CB983998 Inspector Assignment: RB ---
Title: 3700 SF TI-WALLS,CEIL,MECH,ELC
Description: PLUMB-TERMINIX
Type:ITI
Job Address:
Suite:
Location:
Sub Type:
2221 LAS PALMAS DR
C Lot
PMENTCO
'------
Phone: 7604710421
Inspector:
Total Time: Requested By: DAVE GOULD
Entered By: CHRISTINE
CD Description
t9 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Act Comments
.A.2__· -----------
_j_-----'---------t------------
---------------------'--------------------
Inspection History
Date Description Act lnsp Comments
4/14/99 84 Rough Combo AP RB T-BAR COMPLETED -D & C STE
4/13/99 84 Rough Combo co RB FOR T BARJNSP
3/30/99 17 Interior Lath/DryWall AP RB COMPLETED "B & C BLDGS"
3/30/99 34 Rough Electric AP RB WALLS @ BLDG C
3/26/99 17 Interior Lath/Drywall co RB PAY RE-INSP FEE /MISSING RECPT.
3/25/99 14 Frame/Steel/Bolting/Welding AP RB
3/25/99 16-lnsulation AP RB
3/25/99 34 Rough Electric:: PA RB ND RECEPI @ BATHRM
3/23/99 14 Frame/Steel/Bolting/Welding co RB SEE NOTICE
3/23/99 34 Rough Electric co RB
2/26/99 89 Final Combo PA RB OK TO OCC STE "D"
2/23/99 89 Final Combo co RB SEE NOTICE ATTACHED
2/16/99 14 Frame/Steel/Bolting/Welding AP RB FORT-BAR CEILING
2/16/99 24 Roughffopout WC RB
2/16/99 34 Rough Electric AP RB
2/16/9~ 44 Rough/Ducts/Dampers PA RB OK EXCEPT FOR WA.REHOUSE EXHAUST
2111199· 14 Frame/Steel/Bolting/Welding co RB STE "D" T-BAR INSP
2/11/99 24 Roughffopout WC RB ,,
City of Carlsbad Inspection Request
For: 2/16/99
Pe,rmit# CB983998 Inspector Assignment: RB ---
Title: 3700 SF Tl-WALLS,CEIL,MECH,ELC
Description: PLUMB-Tl;:RMINIX
Type:ITI
Job Address:
Suite:
Location:
Sub Type:
2221 LAS PALMAS DR
C Lot
!\PPLICANT : BARBARA WHARTON
Owner: GILDRED DEVELOPMENT CO
Remarks: CEILING INSP
Total Time:
CD Description Act. Comments
Phone: 7604710421
Inspector:
Requested By: DAVE
Entered By: CHRISTINE
14 Frame/Steel/Bolting/Weldins;i
24 Rough/Topout
...i:.E.,__....G ....... -c:--•~7=_-__ J.-.b"""-...,--__._C""-",e,'-"-/ ..... !i~~--
U/'c... ___________________ _
34 Rough Electric, .i_f_ __________ .........;. _____ .,...._ __________ _
44 Rough/Ducts/Dampers ~ l/tf"H:c'4;e Y--?i
--· -----,---------,-
Inspection History
Date Description Act lnsp Comments
2/.11'199 14 Frame/Steel/Bolting/Welding co RB STE "D" T-BAR INSP
2/11/99 24 Rough/Topout WC RB
2/11/99 34 Rough Electric AP RB
2/11/99 44 Rough/Ducts/Dampers co RB @STE"D"
2/10/99 84 Rough Combo NR RB NEED FIRE DEPT APPRVL 1ST
2/2/99 14 Frame/Steel/Bolting/Welding AP RB CORRECTIONS OK
2/2/99 17 Interior Lath/Drywall AP RB
2/2/99 34 Rough Electric AP RB
2/1/99 14 Frame/Steel/Bolting/Welding CA RB BY DAVE
2/1/99 17 Interior Lath/Drywall CA RB
1/29/99 17 lhterior Lath/Drywall co RB ND CORREC FOR FRMG INSP.
1/26/99 14 Frame/Steel/Bolting/Welding PA RB SE~ CORR ATTACHED -OK TO D.W.
1/26/99 24 Rough/Topout NR RB
1/26/99 34 Rough Electric PA RB WALLS OK
1/26/99 44 Rough/Ducts/Dampers NR RB
1/19/99 14 Frame/Steel/Bolting/Welding co RB SEE CORRECTION NOTICE A TT ACHED
1/19/99 24 Rough/Topout co RB
1/19/99 34 Rough Electric co RE!
CARLSBAD FIRE DEPARTMENT
2560 Orion Way, Carlsbad, Caiifornia 92008
931-2121
INSPECTION NOTICE
(Final Notice)
·~c
Page ___ of ___ _
Notice No. _____ _
Date 6 -1 u -:-q !
Phone '-/ ~ S -7 7 6 g
Owner, ·Occupant or Manager-----------------------------Phone ______ _
Address -------------------------------City _____________ _
The items listed below are 9'VIOLATIONS WAEQUIREMENTS D (OTHER) ___________ _
ft. .· . "it· .
' ~··' .... , ... ·
t., ) ·, \ \
c...od
a..,+ Yte ,,,-;-
i
DK. ~h6fq~ r,(3 r .
FINAL NOTICE
EsGil Corporation
1.n Partnersnip witn (jovemment for '.Bui(iing Safety
DATE: 1/ 6/ 99
JURISDICTION: Carlsbad
PLAN CHECK NO.: 98-3998 SET:111.
~ANT
~
D PLAN REVIEWER
D FILE
PROJECT ADDRESS: 2221 ias Palm.as Dr. Ste. C
PROJECT NAME: Terminix TI
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the judsdiction's building codes. · ·
• The plans transmitted herewith will sub~tantially comply with the jurisdiction's building codes
when minor deficiencies identified in Remarks below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and. sh9uld be corrected and resubrni~ed for a complete recheck.
D The ,check list transmitted herewith is for your information. the plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D.
D
D •
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 Corporation staff did not advise the applicant that the plan check has been completed .
Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: lnter-Arch/Penne Horn
Date contacted: (by: )
In person plan review
Fax#:
Mail Telephone Fax In Person
• REMARKS:· Please ma1(/lfe'notes as in red on sheets 0~ ,O:;, 1~, M~ on· the two
perforated Set Ill plans to the City Set II plans and change to City Set IJI. Please have the
Fire .Department review and approve the Hazardous Material Te.chnical Opinion and
Report. Penne Horn from Inter-Arch will carry two perforated Set Ill plans to the City of
Carlsbad Building Department today as per approval from Mike Peterson. Penne Horn
was advised that a permit may or may not be issued at the time of delivery of the plans.
By: Mike Puckett
Esgil Corporation
D GA D MB D EJ .D PC log
Enclosures:
trnsmtl.dot
9320 Chesapeake Drive, Suite 208 + San Diego, California 921:23 + (619) 560-1468 + Fax (619) 560-1576
DATE: 12/18/98
JURISDICTION: Carlsbad
PLAN CHECK NO.: 98-3998
EsGil Corporation
'l:n Partnersliip witli (iovemment for '.Builaing ,$afetg
SET:11
PROJECT ADDRESS: 2221 Las Palmas Dr. Ste. C
PROJECT NAME: Te,rminix TI
0 _Af:e.b!_CANT
C(__JJJ.8.lS~
0 PLAN REVIEWER
0 FILE
0 The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's building codes.
when minor deficiencies identified below are resoived and checked by building department staff.
D 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
Corporation until corrected plans are submitted for recheck.
D 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:
Inter Arch
4141 Jutland Dr. Ste. 320 San Diego, California 92117 FAX# 619-273-4141
• Esgil Corporation staff did not advise the applicant, except by mail or Fax, that the plan check
has been completed. ·
D Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: (by: ) Fax#:
Mail Telephone Fax In Person
• REMARKS: The Fire Department to please review the Hazardous Materials Information-
.provided with this plan review.
By: Mike Puckett
Esgil Corporation
D GA D MB D EJ D PC
Enclosures:
12/14/98 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 + Sat). Diego, California 92123 + (619) 560-1468 + Fax (619) 560-1576
Carlsbad 98-3998
12/18/98
GENERAL PLAN CORRECTION LIST
JURISDICTION: Carlsbad PLAN CHECK NO.: 98-3998
.PROJECT ADDRESS: 2221 Las Palmas Dr. Ste. C
. DATE PLAN RECEIVED BY
ESGIL CORPORATION: 12/14/98
REVIEWED BY: Mike Puckett
FOREWORD (PLEASE READ):
DATE REVIEW COMPLETED:
12/18./98
This plan review is limited to the technical. requirements contained in the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical ·Code and state laws
regulating energy conservation, noise attenuation anc;l disabled access. This plan review is
based on regulations enforced by the Building Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department
or other departments.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans. will be in conformance with the cited codes and regulations. Per Sec. 106.4.3,
19.94 Uniform Building Code, the approval of the plans does not permit the violation of any
state, county or city law. · ·
Please make all corrections on the original tracings and submit three new sets of prints to:
ESGIL CORPORATION.
To facilitate rechecking, please identify, next to each item, the sheet of the plans upon
which each correction on this sheet has been made and return this sheet with the
· revised plans.
Please indicate here if any changes have been rnade to the plans that are not a r~sult of
corrections from this list. If there are other changes, please briefly describe them and where
they are located on the plans. Have. changes been made not resulting from this list?
0 Yes D No
Carlsbad 98-3998
12/18/98
The following corrections are items· not completely addressed from the previous plan
review or are in response to new information provid,ed.
1. Item #3 On the first sheet .of the plans please revise or add the correct information:
.Present and proposed occupancy classifications of the remodel area, Note, the
Occupancies are B/S1 and maybe different if rnandated by the Hazardous Materials
report. Please revise the floor plan -Occupancy Groups also. In light of the incomplete
information provided by t~e hazardous. material report the occupancy
classifications for the parking and. chemical storage are to be determined pursuant
to the hazardous materials plan revjew findings. A Complete plan review cannot
be done without correctly determining the ·occupancy groups.
+ PLUMBING AND MECHANICAL CORRECTIONS
+ JURISDICTION: Carlsbad
+ PLAN ·REVIEW NUMBER: 98-3998
+ PLAN REVIEWER: Glen Adamek
. DATE: 12/21/98
SET: II
2. Provide. a complete Hazardous Material Technical Opinion and Report, as per UBC,
Section 307.
a) Provide a summery of the proposed hazardous materials. .
i) For each material clearly show· all the hazardous classifications as per the
USC, Table 3-D ·and 3-E classifications.
ii) Clearly show the amounts of each type of hazardous material to be stored.
How much hazardous material is in each "case" and each "box"?
iii) Clearly show where in the buildings each type of hazardous material is
being stored. · ·
iv) Clearly show how the hazardous material is being stored at each locations.
(In cabinets, on trucks, on shelve.s or. .. ?)
v) Clearly show the amounts of each type of hazardous material to be in use.
vi) Clearly show where in the buildings each type of hazardous material is
beirig used.
vii) Clear.ly show how each type of hazardous material is being used.
b) Please address the separation of incompatible materials.
c) Please address required fire rated occupancy separation.
d) Provide calculations for required containment in ·each area of the buildings, as per
USC, 307.2.5.
e) Provide a written response to show how Spill Control and Drainage are being
handled as required in USC, Sections 307.2.3 & 307.2.4.
f) Please address the required ventilation.
Carlsbad 98-399.8
12/18/98
g) Detail exhaust ventilation system -compliance with UMC Chapters 5 & 6.
i) Detail the required make-up air as per UMC, Section 505.6.
ii) Detail the exhaust outlet clearances as per UMC, Section 609.10.
jjj) Clearly show the type of material to be exhausted by each exhaust system.
iv) Clearly show the duct materials are suitable for .the intended use. UMC,
Section 609.1
v) Clearly show the exhaust duct material and gage used for each duct size.
See UMC, Table 5-B.
vi) Detail ducts conveying explosives or flammable vapors, fumes or dusts
shall extend directly to the exterior of the building without entering other
spaces. UMC, Section 505.1.
vii) Detail miniml!h1 duct conveying velocities as per UMC, Section 505.4 and
Table 5-A.
viii). Detail duct cleanouts as per UMC, Section 609.4.
ix) Detail required explosion venting of dust collection systems as per UMC,
Section 609.5.
x) Detail duct support as per UMC, Section 609.6.
xi) Detail fire protection as per UMC, Section 609.7.
xii) Oetail. clearances from combustibles as per UMC, Section 609.8.
xiii) Detail protection from physical damage as per UMC, Section 609.9 .
. h) .Provide the required manual shutoff control for ventilation equipment as per UBC,
Section 1202.2.3.
i) For fumes or vapors that are heavier than air, exhaust shall be taken from a point
within 12 inches of the floor. UFC, section 8003.18.2-5.
Note: If you have any questions regarding this Plumbing and Mechanical plan review list please
. contact Glen Adamek-at (619) 560-1468. To speed the review process, note on this list
(or a copy) where the corrected items have been addressed on the plans.
~ The jurisdiction has contracted w_ith Esgil Corporation located at 9320 Chesapeake
Drive, Suite 208, San Diego, California 92123; telephone number of 619/560-1468, to
perform the plan review for your project. If you: have any questions regarding these plan
review items, please contact Mike Puckett at Esgil Corporation. Thank you.
. ,.
DATE: 12/4/98
JURISDICTION: Carlsbad
PLAN CHECK NO.: 98-3998
EsGil Corporation
'ln Partnersliip witli (jovemment for 'lJuiuling Safety
SET:I
PROJECT ADDRESS: 2221 Las Palmas Dr. Ste C
PROJECT NAME: Terminix Tl
D AP£LICANT
s:]uR1s:)
D PLAN REVIEWER
D FILE
D The plans transmitted herewith have been corrected where necessary a.nd substantially comply
with the jurisdiction's building codes. ·
D The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
D 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 ihformation. The plans are being held at Esgil
Cor.poration until corrected. plans are submitted for recheck.
·D The applicant's copy of the check list is enclosed for the juri~diction to forward to the applicant
contact person.
·• The applicant's copy of the check list has been sent to:
Larry Wharton
639 Bison Gt. El ~ajon, Ca. 9~019
• .Esgil Corporation staff did not advise the applicant, except by mail, that the plan check has
been completed. · ·
D Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: (by: ) Fax #:
Mail Telephone Fax In-Person
D REMARKS:
By: Mike Puckett
Esgil' Corporation
D GA D MB' D EJ D PC
Enclosures:
11/23/98 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (619) 560-1468 + Fax (61~) 560-1576
Carlsbad 98-3998
12/4/98
PLAN REVIEW CORRECTION LIST
TENANT1MPROVEMENTS
PLAN CHECK NO.: 98-3998
OCCUPANCY: :S/S1
TYPE OF CONSTRUCTION: VN
ALLOWABLE FLOOR AREA:
SPRINKLERS?: Yes
.REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 11/19/98
,DATE INITIAL PLAN REVIEW
COMPLETED: 12/4/98
FOR(:WORD {PLEASE READ):
JURISDICTION: Carlsbad
USE: Office/Warehouse
ACTUAL AREA: 3,700sf Office
3,800sf Warehouse
STORIES: 1
HEIGHT:
OCCUPANT LOAD: 45TI
DATE PL.ANS RECEIVED BY
ESGIL CORPORATION: 11/23/98
PLAN REVIEWER: Mike Puckett
This plan review is limited to the technical requirements contained in_ the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws
regulating energy conservation, noise attenuation and access for the disabled. This plan review
is based on regulations enforced by the Building. Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department,
Fire Department or other departments. . Clearance from those departments may be required
prior to the. issuancE: of a building permit.
Code sections· cited are based on the 1994 USC.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3,
1994 Ur-iiform Building Code; the approval of the plans does not permit the violation of any
state, county or city law.
To speed up the recheck .process, please note on this list (or a copy) where ·each
correction item has been addressed, i.e., plan sheet number, specification section, etc.
Be sure to enclose the marked up list when you submit the revised plar:1s,
LIST NO. 40, TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1994UBC) tiforw.dot
Carlsbad 98-3998
12/4/98·
1. Please make all corrections on the original tracings, as requested in the
correction list.
Submit three sets of plans for commercial/industrial projects (two sets of
plans for residential projects). For expeditious processing, corrected sets can be
submitted in one of two ways:
1. Deliver all corrected sets of plans and calculations/reports directly to the
.City of Carlsbad Building Department, 2075 Las Palmas Drive, Carlsbad, CA
92009, (760) 438-1161. The City will route the plans to EsGil Corporation and the
Carlsbad Planning, Engineering and Fire Departments.
2. Bring one.corrected set of plans and calculations/reports to EsGil
Corporation, 9320 Ctiesapeake Drive, Suite 208, San Diego, CA 92123, (619)
560:..1468. Deliver all remaining sets of plans and calculations/reports directly to
the City of Carlsbad Building Department for routing to their Planning, Engineering
and Fire Departments.
NOTE: Plans that are submitted directly to EsGil Corporation only will not
be reviewed by the City Planning, Engineering and Fire Departments until review
by EsGil Corporation is complete.
2. Each sheet of the plans must be signed by the person responsible for their
preparation, even though there are no structural changes. Business and
Professions Code. The Mand E sheets are not signed.
3. On the first sheet of the plans please revise or add the correct information:
a) Present and proposed occupancy classifications of the remodel area,
Note,. the Occupancies are B/51 and maybe different if mandated by the
Hazardous Materials report. Please revise the floor plan Occupancy
Groups also.
b) Please revise the number of stories. Are there really 24?
c) The occupant load of the remodel area(s). ·
4. Please provide a fully dimensioned floor plan. Section 1.06.3.3. Dimension the
restrooms and .show the 60" clear"inscribed manuvering circle within the
restrooms. Dimension the overall tenant space to be created.
5. Please indicate the U$e of all spaces adjacent to the area being remodeled or
improved.
6. Please show any existing fire rated area separation walls, occupancy separation
walls, demising walls, shafts or rated corridors.
Carlsbad 98-3998
12/4/98
7. · A complete description of the activities and processes that will occur in this
tenant space should be provided. A listing of all hazardous materials should be
included. The materials listing should .be stated in a form that would make
classification in Tables 3-D and 3-E possible. The building official may require a
technical report to identify and develop methods of protection from hazardous
materials. Section 307.1,6. Provide data on proposed hazardous material to be
stored and used. USC, Section 307 and. UFC.
a) Cl_1;3arly show types of hazardous material is being stored or used. Provide
a list of the proposed hazardous materials as per the types in UBC,
Tables 3-D, and 3-E. Provide the material safety data sheets (MSDS).
· b) Clearly show the amounts of each type of hazardous material to be stored
·and in use.
c) Clearly show where in the buildings each type of hazardous -material is
being stored or used.
$. Please show the size of the proposed windows to be installed in the partition walls.
Show tempered gla~dng if applicabl~ per UBC 2406.4
9. At detail D/3.1 please show on the detail a slip track device to be installed at the
connection of the wall to the roof structure above.
10. In Groups B,·F, H, Mand S Occupancies, if the number of employees exceeds
four, provide separate toilet facilities. for men and women. Section 2902.3.
Please -designate the sex of the restrooms on the plans.
11. Please remove the. exit sign from the door leading into the Warehouse. An exit
cannot pass through a warehouse.
12. Provide mechanical ventilation in all rooms capable of supplying outside air at a
minimum rate of 15 cubic feet per minute per occupant. UBC, Section 1202.2.1
Even though the HVAC equipment is existing, please show the cfm of required
outside air on the M sheets.for the revised tenant space occupant load.
13. ·Provide complete plumbing plans, including:
a) Complete drain, waste and vent plans.
b) Provide gas line plans and calculations, showing pipe lengths and gas
demands. UPC Section 1217.0 1.f applicable.
c) Provide complete water line sizing calculations, including the water
pressure, pressure losses, water demands, and developed pipe lengths.
UPC Section 610;0
d) Show water heater size, type where shown on plans. UPC, Section 501.0
Two water heaters are shown but only one listed on the electrical panel
schedule, please clarify
Carlsbad 98-:3998
1~/4/98
14. Show that water heater is adequately braced to resist seismic forces. Provide
two straps (one strap at top 1/3 of the tank and one strap at bottom 1/3 of the
tank). UPC,. Section 51'0.0
15. Show P & T valve on water heater and detail drain line route from P & T valve to
the exterior. UPC Section 608.5.
16. Please show the restroom fan exhausts in the restrooms capable of providing a
complete change of air every 15 minutes.
To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes, please briefly
describe them and where they are located in the plans.
Have changes been made to the plans not resulting from this correction list?
Please indicate:
Yes D No o·
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of
619/560-1468, to perform the plan review for your project. If you have any
questions regarding these plan review ·items, please contact Mike Puckett at
Esgil Corporation. Thank you.
Carlsbad 98-3998
12/4/98
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad PLAN CHECK NO.: 98-3998
PREPARED BY: Mike Puckett DATE: 12/4/98
BUILDING ADDRESS: 2221 Las Palmas Dr. Ste C
BUILDING OCCUPANCY: B/S1 TYPE OF CONSTRUCTION: VN
I BUILDING PORTION I BUILDING AREA VALUATION VALUE
(ft.2) MULTIPLIER ($)
Tenant Improvement 3700 Office 28.00 103,600.00
..
Air Conditioning
Fir~ Sprinklers
. TOTAL VALUE 103,600.00
.. . .
D 1994 USC Building Permit Fee • Bldg. Permit Fee by ordinance: $ 635.08
D 1-994 · USC Plan Check Fee • Plan Check Fee by ordinance: , $ 412.80
type of Review: D Complete Review . · D Structural Only D Hourly
D Repetitive Fee Applicable D Other:
· Esgil Plan Review Fee: $ 330.24
Comments:
Sheet 1 of 1
macvalue.doc 5196
City of Carlsbad
• 3 ,, ... Ii§§ iht• I •2§ •Si I;, ,i§ '''
BUILDING· PLAN CHECK CHECKLIST
DATE: (BI, lt:tB PLANCHECK NO.: CB tf'83t/9{3
BUILDING A6D~ESS: :J aol. , Lg,s . Pa 1 ~ J)[)l\.t:€. ,. S, nA-e c..
PROJECT DESCRIPTION: ___ . _;<"l:....::X=C.;;;;;; ____________ "---,-__________ _
ASSESSOR'S PARCEL NUMBER: ..2_L~-:--Osfo -:J I EST. VALUE:
ENGINEERING DEPARTMENT
APPROVAL DENIAL
The item you have submitted for review .has been
approved. The approval is based on plans,
information and/or specifications provided in your
submittal; therefore any changes to these items after
this date, including field modifications, must be
reviewed by this office to insure continued
conformance with applicable codes. Please review
carefully all comments attached, as failure to comply
with instructions in this report can result in
suspension of permit to build.
I]. Right-of-Way permit is required prior to
construction of the following improvements:
Piease see~h attached report of deficiencies
marked with . Make necessary corrections to plans
or specificatio s for compliance with applicable
codes and standards. Submit corrected plans and/or
specifications to this office for review.
FOR OFFICIAL USE ONLY
ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT:
0 Dedication Application
D Dedication Checklist
D Improvement Application.
D Improvement Checklist
D Future Improvement Agreement
0 Grading Permit Application
0 Grading Submittal Checklist
D Right-of-Way Permit Application
D Right-of-Way Permit Submittal Checklist
and Information Sheet
D Sewer Fee Information Sheet
Date:
ENGINEERING DEPT. CONTACT PERSON
Name: ~OANNE JUCHNIEWICZ
City of Carlsbad
Address: 2075 Las Palmas Dr., Carlsbad, CA 92009
Phone: (619) 438-1161, ext. 4510
CFD INFORMATION
Parcel Map No:
Lots:
Recordation:
Carlsbad Tract:
A-4
H,1woR01~fflsfliaisiopammcoose1t!!,t1.F!lffl@arlsbad, CA 92009-~576 • (760) 438-1161 • FAX (760) 4'8.1~69
0
BUILDING PLANCHECK CHECKLIST
SITE PLAN
1. Provide·a fully dimensioned site plan drawn to scale. Show:
A. North Arrow
B. Existing & Proposed Structures
C. Existing Street Improvements
2. Show on site plan:
A. Drainage Patterns .
D. Property Lines
E Easements
F. Right-of-Way Width & Adjacent Streets
G. Driveway widths
1. Building pad surface drainage must maintain a minimum slope of one
percent towards an adjoining street or an approved drainage course.
2. ADD THI= FOLLOWING NOTE: "Finish grade will provide a minimum positive
drainage of 2% to swale 5' away from building."
X
Existing & Proposed Slopes and Topography x/.~ Include on title sheet:
CJ.
0 (J CJ
A.
8.
C.
Site address
Assessor's Parcel Number
Legal Description
~or commercial/industrial buildings and tenant improvement projects, include:
total building square footage with the square footage for each different use,
existing sewer permits showing square footage of different uses (manufacturing,
warehouse, office, etc.) previously approved.
EXISTING PERMIT NUMBER DESCRIPTION
DISCRETIONARY APPROVAL COMPLIANCE
4a. Project does not comply with the· following Engineering Conditions of approval for
Project No. _______________________ _
4b. All conditions $re in compliance. Date: _________ _
H:IWORDIDOCSICHKLSnBuildIng Planche<;k C:klst BP0001 Fonn JJ.doc 2 Rev. 12/26/96
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BUILDING PLANCHECK CHECKLIST
DEDICATION REQUIREMENTS
5. Dedication for all street Rights-of-Way adjacent to the building site and any storm
drain or utility easements on the building site is required for all new buildings and
for remodels wlth a varue at or exceeding $ ______ , pursuant to Carlsbad
Municipal Code Section 18.40.030.
Dedication required as follows: _ __;,. ______________ _
Dedication required. Please have a registered Civil Engineer or Land Surveyor
prepare the appropriate legal description together with an 8 ½" x 11" plat map
and submit with a title report. All easement documents must be approved and
$igned by owner(s) prior to issuance of Building Permit. Attached please find an
application form and submittal checklist for the dedication process. Submit the
completed application form with the required checklist items and fees to the
Engineering Department in person. Applications will not be accept by mail or fax.
Dedication completed by:____________ Date: ___ _
IMPROVEMENT REQUIREMENTS
6a. All needed public improvements upon and adjacent to the building site must be
constructed at time of building construction whenever the value of the
construction exceeds$...,.,.....,....------' pursuant to Carlsbad Municipal Code
Section ·18.40.040.
Public improvements required as follows: ____________ _
Attached please find an applic~tion form and submittal checklist for the public
improvement requirements. A registered Civil Engineer must prepare the
appropriate improvement plans and submit them together with the requirements
on the attached checklist to the Engineering Department through a separate plan
check process. _ The completed application form and the requirements on the
checklist must be submitted in person. -Applications by mail_ or fax are not
accepted . .Improvement plans must be approved, appropriate securities posted
and fees paid prior to issuance of building permit.
Improvement Plans signed by: ----,---------Date: ___ _
6b. Construction of the public improvements may be deferred pursuant to Carlsbad
Municipal Code Section 18.40. Please submit a recent property title report or
current grant deed on the property and processing fee of $ _______ so
we may prepare the necessary Future Improvement Agreement. This agreement
must be signed, notarized and approved by the City prior to issuance of a
Building permit.
Future public improvements required as follows:
H:IWORDIDOCS\CHKLSnBuildmg Plancheck (,klst BP0001 Fann JJ.doc 3 Rev. 12/28196 . J
1st,/ 2nd,/ 3rd,/
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BUILDING PLANCHECK CHECKLIST
6c. Enclosed please find your Future Improvement Agreement. Please return
agreement signed and notarized to the Engineering Department.
Future Improvement Agreement completed by:
Date:
6d. No Public Improvements required. SPECIAL NOTE: Damaged or defective
improvements found adjacent to building site must be repaired to the satisfaction
of the City Inspector prior to occupancy.
GRADING PERMIT REQUIREMENTS
The conditions that invoke the need for a grading permit are found in Section
· 11.06.030 of the Municipal Code.
?a. Inadequate information available on Site Plan to make a determination on grading
requirements. Include accurate grading qtJantities (cut, fill import, export).
7b. Grading Permit required. A separate grading plan prepared by a registered Civil
Engineer must be submitted together with the completed application form
attached. NOTE: The Grading Permit must be issued and rough grading
approval obtained prior to issuance of a Building Permit.
Grading Inspector sign off by: Date:
7c. Graded Pad Certification required. (Note: Pad certification may be required even
if a grading permit is not required.)
?d.No Grading Permit required.
?e.lf grading is not required, write "No. Grading" on plot plan.
MISCELLANEOUS PERMITS-
8. A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or
private work adjacent to the public Right-of-Way. Types of work include, but are
not limited to: street improvements, tree trimming, driveway construction, tieing
into public storm drain, sewer and water utilities.
Right-of-Way permit required for:
H:IWORO\OdCS\CHKLSnBulldlog Pianchei:k Cklst BP0001 Fonn JJ.doc
BUILDING PL,ANCHECK CHECKLIST
4 Rev. 12/26196
•
9. A SEWER PERMIT is required concurrent with the building permit issuance. The
fee is noted in the fees section on the following page.
10. INDUSTRIAL WASTE PERMIT If your facility is located in the City of Carlsbad
sewer service area, you need to contact the Carlsbad Municipal Water District,
located at 5950 1::1 Camino· Real, Carlsbad, CA 92008. District personnel can
provide forms and assistance, and will check to see if your business enterprise is
on tt,e EWA Exempt List. Yoµ may telephone (760) 438-2722, extension 153, for
assistance.
Industrial Waste permit accepted by:
Date:
11. NPDES PERMIT
Complies with the City's requirements of the National Pollutant Discharge
~limination System (NPDES) permit. The applicant shall provide best
management practices to reduce surface pollutants to an acceptable level prior to
discharge to ·sensitive areas. Plans for such improvements shall be approved by
/
the City Engineer prior to issuance of grading or building permit, whichever
occurs first. ·
. .
,
12. a B,eq(iired fees are attached
E:r'"No fees required
13. Additional Comments: ---.
fees CO-A:,~ l.s2-~£0-J. v-M D.. ~de'""-I 6)( ~ i¼-\:: 1 --Ll> f2:-~ s£z,-c e ~;r~A--00~ 1 tr o ,
H:\WORD\OOCS\CHKLSnBuilding Plancheck Cklst BP0001 Fann JJ.doc 5 Rev 12/26196
PLANNINC/ENCINEERINC APPROVALS
, PERMIT NUMBER CB f''t/; "${1 f DATE-.--/_/_-_c;_5f-_1tf __
"ADDRESS ___ d_'J-_'l _I -~-------..1.-t_lY_~ ____ · ~-----~-~~------
-RESIDENTIAL
RESIDENTIAL ADDITION MINOR
-< < $10,000.00)
OTHER
TENANT IMPROVEMENT
PLAZA CAMINO REAL
CARLSBAD COMPANY STORES
VILLACE FAIRE
COMPLETE OFFICE BUILDINC
---------------------------
PLANNER DATE __ ~_1/._v_~_;ff __
ENCINEER ----------DATE -------
Does/Mlstorms/Planning Engineering Approvals
City of Carlsbad · __ 98376
Fire Department • Bureau of Prevention
Phtn Review: Requirements Category: Building Plan Check
Date of Report: Wednesday, February 24, 1999 Reviewed by: __ M ___ ~-«t----
Contact Name Larry Wha.rton
Address 639 Bison Ct ---------------------------------------
City, State El Cajon_CA 92019
Bldg. Dept. No. CB983_~98 Planning No.
Job Name I Terminex/C --------------------------------------------
Job Address 2221 Las Palmas . Ste. or Bldg. No. --~--
jg! Approved -The item you have submitted for review has been approved. The approval is
based on plans; information and/Or specifications provided in your submittal;
therefore. any changes to these items after this date, including field modifica-
tions, must be reviewed by this office to insure continued conformance with
applicable codes. Please review carefully all comments attached, as failure
to comply with instructions in this report can result in suspension of permit to
construct or install improvements.
D Disapproved -Please see the attacbed report of deficiencies. Please make corrections to
plans or specification~ necessary to indicate compliance with applicable
codes and standards. Submit corrected plans and/or specifications to this
office for review.
For Fire Department Use Only
Review 1st ~--2nd~--3rd·-----
CFD Job# 98376
Other Agency ID File# ______ _
2560 Orion Way • Carlsbad, California 92008 • (619) 931-2121
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TERM/NIX} t ;,
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The Nationwide Pest Control Experts The Terminix International
Company L. P.
2221 Las Palmas Drive, #C
Carlsbad, CA 92009
Office: 760/438-7768
Fax: 760/438-7999
Plan Check No. 98-3998
Project Name: Tenninix TI
December 29, 1998
EsGil Corporation
9320 Chesapeake Drive, Suite 208
San Diego, CA 92123
Attn: Mike Puckett
Dear Sirs;
----The following information being submitted is the Hazardous Material Technical Opinion
· and Report, as per UBC, Section 307.
Items 2. A) 1) through 2. A) VII) are addressed on the attached table.
This fist has been revised to include only those materials we use, which fall under the
UBC Tables 3-D ancl 3-E classifications for Hazardous Materials.
Item 2. B) N/ A
Item 2. C) See Risk Management Bulletin item 2 (Fire Walls)
Item 2. D) See Risk Management Bulletin items 1,6 (Isolation, Spill Containment)
Item 2. E) See Risk Management Bulletin items 5,6 (Floor S~alant, Spill
Containment)
Item 2. F) See Risk Management Bulletin item 4 (Ventilation)
Please let us know if we can be of any further assistance.
~,ectfully submitted,
il~1~ernationill
Attachments ( 5 pages, 2 pictures)
q)f?f79i
•
_Ca_ll--J __ -8'-"-0--0---W:='E....:;.SE=Rc;;..;V:....::'E:...__,,_,
ServiceMaster • Tcrminix • Merry Maids
,. TruGrecn-Cheml..awn • American Home Shield
Furniture Medic • AmcriSpec
,~
TERM/NIX INTERNATIONAL
This table addresses items 2.a) I-VII
Hazardous Material 2.a) 1} 2. a) 11) 2. a) Ill) 2:. a) IV) 2. a) V) ~ 2. a) VI) 2. a) VII)
Knox Out TKO Table3-E 120-gallons Existing metal on shelves -.. NIA NIA -~-.---JI~ W~'-11·
(Diazinon) Liquids Toxics 1 case=6x63oz chemical storage oermonth
40 cases max. shed t2/' ... ,AJ 1714"
~/ (juu.6'
I
Contrac Pellet Pack Table3-E 34 oounds Existing metal on shelves 1 O oounds used NIA NIA
(Bromadiolone) Solids Toxics 1 case= 120 X 1.5oz · chemical storage -.. oermonth
3casesmax. shed '-~
j
Contrac Blox Bell Table3-E 160 oounds Existing metal on shelves' 50 oounds used . NIA NIA
l(Bromadiolone) Solids Toxics 1 case = 4 x 4Ibs chemical storaQe · ( oermonth
10 cases max. shed ..... I',..\. ~ -
Pictures attached.
""""·
DEC-29-1998 TUE 09:02 AM AM SVCMASTER RISK MGMT FAX NO. 9017661495 P. 02
...
TO:
FROM:
DATE:
CONSUMER SERVICES
RISK MANAGEMENT BULLETIN
Regional Managers
William M, Wainscott
May 18, 1993
CHEMICAL STORAGE R001\t1 REQUIR:El\tIENTS -· -
Our current insurance policies exclude pollution coverage for all owned or leased premises.
Any type of chemical related problems which occur at a branch are uninsured. Because of
the insurance exclusion for branch locations, it is necessary to require chemical storage areas
to meet certain minimum requirements. These requirements are also necessary to ensure
complfance with local, state and federal regulations. When selecting a branch location or
negotiating a lease, the following must be considered. These conditions should also be
considered whenever you. relocate or renovate a chemical storage area for an existing branch.
l. ISOLATION: The chemical storage area must be isolated from other areas of
the branch and must be away from the office area in a location that is used
exclusively for the storage of chemicals. At no time are chemicals to be
stored in the office area.
2. FIRE WALLS: Chemical storage rooms located inside the branch facility
must be separated from other areas of the branch with a minimum of a two--
hour fire wall. All doors lea.ding into the chemical storage area must have a
minimum of a two~hour fire rating. Where applicable, the ceiling of the
storage area must also have a minimum of two-hour fire rating.
3. OUTSIDE CONTAINER: Where necessary, outside storage containers are
acceptable. Th~e containers must be approved hazardous material storage
containers with self~contained sump pits. The storage units must be placed as
close as possible to the building and must be on a sealed slab with curbing for
secondary containment. Electrical connections must be in accordance with
local and state fire and building codes (explosion proof wiring and lighting).
Heating and air conditioning may be added to these storage units as required
but must be installed in strict compliance with local fire and building codes.
., . ... •1,
DEC-29-1998 TUE 09:02 AM AM SVCMASTER RISK MGMT FAX NO. 9017661495 P. 03
. •'
Chemical Storage Room Requirements
May 18, 1~93
Page two
4. VENTILATION: The chemical storaae area must be properly vented to the
outside, The ventilation system must have the capacity to provide a minimum
of six complete air exchanges per hour.
5. FLOOR SEALANT; The floors in chemical storage areas, as well as
warehouse areas, must be sealed with an approved epoxy floor sealer.
Particular attention should be paid to the .sealing of all floor joints, as well as
areas where chemicals .are mixed and/or dispensed,
6, SPILL CONTAINMENT: The chemical storage area should be curbed or
diked for spilt containment. The curbing must have the capacity to contain
125 % of the maximum amount of the liquids to be stored in the area at any
one time. Curbing must extend across all doorways and wall openings. Floor
drains and sump pump pits are not allowed within the curbed area. The area
within the curbing must be a sea.led with art epoxy floor sealer as noted in
requirement above. ·
7. SHELVING: All shelving must be made of met.al or similar non-absorbent
material. Wooden shelves are not to be used.
8. FUMIGATION STORAGE: Aii fumigants must be stored in an outside
storage facility detached from the main building. This storage unit should be
in strict compliance with local building and zoning codes. When necessary,
and when allowed by state or local regulations, fumigants may be stored
inside, but must be stored in a sepa{ate room equipped with a special
ventilation Unit. The ventilation system must be designed to pull air from the
floor of the fumigant storage area, provide a minimum of one complete air
exchange every five minutes on a continuous basis 1 and must exhaust air
through the too( of the building.
9. RINSATE/RECYCLE AREAS (Lawn Care Only): The rinsate/recycle area
must be located inside the building, The area must be sloped towards the
central drain or curbed to contain the ri~se water. A U-channel poly drain
shall be installed to ~liminate any underground plumbing or piping, This U·
channel poly drain shall ron into a poly~lined sump pump pit where the water
shall be pumped into an above ground tank. The entite area must be sealed
with an epoxy floor s~er, No underground tanks or undergro1lnd holding pits
shall be permitted. When curbing is installed 1 it must be continuous pour1
fiberglass reinforced concrete installation. Use of asphalt for curbing is not
permitted.
DEC-29-1998 TUE 09:02 AM AM SVCMASTER RISK MGMT FAX NO. 9017661495 P. 04
Chemical Storage Room Requirements
May 18, 1993·
Page Three
10. STORAGE TANK AREAS (Lawn Care Only): Secondary containment shall
be provided around all bulk storage tanks. Such containment shall be strict
compliance with st.ate and local containment regulations. Wherever possible,
bulk storage tanks and secondary containtnent should be located inside the
building. The secondary containment should also be a continuous pour
fiberglass reinforced concrete,
11. CODE COMPLIANCE: All chemical storage areas shall be in strict
compliance with state and 1~ fire, building and zoning codes. Compliance
with such codes should be discussed prior to final site selection to ensu.re local
codes allow intended use~ By addressing code requirements early, in the
process we should he able to pass much of the required improvements and
related costs onto the landlord.
12, FACILITY DRAWING: A floor plan and lot plan should be submitted as pa.rt
of the lease checklist indicating the location of all floor drains, sump pumps,
outside storm sewers, wells, drainage ditches, bodies of water, etc, This will
allow us to identify potential environmental problems and make appropriate
recommendations or provide for necessary corrective action.
The above items are intended to minimize the company's environmental Uabilitles. These
items are guidelines only, Additional items may be required depending on facility location,
surrounding areas;, local and/or state regulations, ~tc. Please contact the Risk Management
Department and/or the Regional Technical Manager to discuss specific environmental
concerns.
,, I
., . l ~
Description of Operations
The company operates a structural pest control operation out of this
location. The termite and pest control operations are performed under
general policies and procedures prescribed by Corporate Headquar-
ters in Memphis, Tennessee, and in compliance with federal, state and
local regulations and guidelines. Most of the chemicals stored on-site
are pesticides similar to those available over the counter to consumers
in most states. All pesticides are EPA and state registered products.
See our Hazardous Chemical Inventory for a list of hazardous chemi-
cals used by this facility.
The company does not manufacture, blend or package any chemicals.
All chemicals at this location are received and stored in the original
manufacturer's container, or labeled service containers, until diluted
for use. All chemicals are handled; stored and used in compliance with
the label directions from the manufacturer. Small quantities of chemi-
cals are stored at this location (45 to 60-day supply, or less), all in small
containers (five gallons or less), with the exception of those products
noted as stored in larger containers on the chemical inventory list.
There are no storage tanks at this location.
There are no hazardous wastes generated at this location. Empty
pesticide containers are triple rinsed before disposal, and the rinsate
used in pesticide application mixtures. Containers are then discarded
in accordance with the manufacturer's label directions.
@j.:• T E R M I N I X S A F E T Y S T A N D A R D S M A N U A L
AUGUST 15, 1994
..
J MATERIAL
SAFETY
DATA SHEET
ELF A TOCUEM NORTH AMERICA, INC.
PRODUCT NAME:
KNOX OUT ~ FM INSEC11CIDE
CODE MJMBER:
9180
BEFORE USIWGPRODUCT. READ AND FOI.LOW·CiREC110NS AND PRECAUT,IONS ON.PRODUCT LABEL AND BULLETINS.
TOXICITY
l'Yl '1 ( A r.t ITF)
LD., (RAT) > 21,000 mg.,kg
DERMAL{ACUTE)
LDJllABBIT) > 10,000 mgAcg
IMiALAT10N(ACUTE}
LC.:,JHAI) > !l!U:J mg/I.
(1 HA FXPOSIIRF)
Cl/Rot-IC. SUBCffiONIC. ETC.
Tllo nmtvr. lnr,r.rllr.nr, dtlilnnn, IA n
-Ju,.c~ba-,c,M,,iLi.~t u.,I.J1 ,oyc-.l-
.,.i.,x11u•u" 11111y I'' uJu1."' .. 1ruubl
M!1nul n~mplnm.'I. O,,rmtmr1-nf nr.i tr.
org11nophosphnlc poisoning lncudo
hmmrhe. rtnh!M, Y..-:lllall':'I.,, llmorrl·
ll'dlU I, IIIWdt, twill:hht\l, ~ l!IIIUI,
nausea, abdomnal cramps, diarrhea,
and swealng.
HEALTH HAZARD
'IFORMATION
EFFEC.TS OF EXPOSURE
IQ QQ({CENTRAT;
PERMISSIBLE EXPOSURE LIMIT
(1I. V/TWA OR CEILINO.[CJ)
ACCU 11001 P!l 11.V/TWA
0.1 mgmi'(skln)
OSHA lWANE
/RR1 T ,._ nON
NA
COAAOSIVJTY
NA
CCNCJTl:V.770N
·NU I A litN~l llLl::H
IMIALA TION EFFECTS NA .
LUNG EFFECTS
NA
HEAL TH HAZARD
INF=ORMA'TION
t:Mt:HUt:NCY, NHS I AIU
_INCES710N
• ~ GET MEDICAL ATTENTION ·oo lilOUf'..E VCIJITINC C oo NOT NDUCE vrumNG L mvi: PLtNI v 91-w>.11:H
00 OTHEn:
AIHU'NL ISI\NIIUUI/IL LNL'f II
S'IMf'Tr.t.4S OF 0-0..INESTEflASE
NiBlfk)N ARE PRESENf.
MUIH INL l!j OONII-WNUlt:.A.ILU
DI.RMAI. C AFT MFOl<'AI ATTFNTlnN i,;i n.001 wm I COA: ANQ WATCO
~ CONTM11M.-.TEO CLOTlilNG
ACMOVC AND LAUNOCA
[: <;:OOTAMINATEO SI-OES-
Ut:!>1 HOY
~ OTHER:
l:11:1 Ml:U1\..AL Al·lt:NII~ Ir
&:YMPTOM6 /\flPEAn
fYF r.ONTAr.T 00 GET MEDICAL ATTENTION 00 A I L'lH WITH Pl FNTY OF WA TFR
FOR AT LEAST 15 MINUTES
INHALAnCN C l-lLI MLLlll.'.AI. Al ILNlll.lll 00 flEMOVE TO FRESH AIR C F NOT BREATiilNG, GIVE
,-nTIFICIAI. nESPlllA Tla-J C GIVF OXYGFN 00 OTHER.
ULI MLUlt:Al A I I LN llet-1 D
CYMl'TOMC ,._fll'D.O
.PREPARED BY:·n. A. Cle.-NER
DA.TE:: 12/02
ADDRESS:
ELF ATOCH:M NOR1H AlvEFIICA. II~
AOCHEM DME:ION, nOOM 810
THAFF PAR<WAY
l'Hll AIIH 1-'HIA, 1-'A 11110?
PHONE:
(lW,)·~11/•/0Ul
SPECIAL
PROTECTION
INFORMATION
YENTILATTON
REQI.IIREMENTS-
Af.WAYS MANT'AIN l;XPOSURE
tit.I. UW t't:HMIS:ilt:ILt:
EXPOSURE LIMITS C Ca-JSUL T AN INDUSTRIAL
HYOIFNl:=iT OR FNVIAONMFNTAI
I !CAI. TI I SPCCIALIST C I rx-:AI no tAt 1::rr 00 IISF wmt AOA:it IATF
· VFNTI ATION C CHECK FOR AIR
t.:llN I MIINAN I ANU
1·1XYl,FN ftFFIC:IFNl'W
EYE
U~L NUHIML ~Al LI Y
'PREC ... UTIONS
1/AND(GLOVE TYPE) L t'U.TYINIL U1LUHIUI: 00 NCOPRCNC 00 Btm'l.. RUBBER 00 NATUF\Al. AWBEA C POL YVINYl ALCOOa. lxJ P\'.A. Yl:TJ1'Tl. ENI! C ANY
RFf.l'IRA TOR TVPF-
Nlll HH .ll llHl-ll·IIHI-NflHMAI
SAFETY PRECAUTIONS
OTI-IER PROTECTIVE
EOU/P/IIENT
WCAA PAOTCCTIVC a.OT! UNO
WI IICI I PRCVCNTS SKIN Ct'."ITACT.
S11per u~er
SPECIAL
PRECAUTIONS
l'Ht:VAU /IUNAHY
LABl=LING
00 WAfil I TI IOROllrn II Y AITrR
HANDLING 00 0(.1 Nl'.IT CET IN EYES, r.t-J SKIN
OR CLOTI-IING 00 DO NOT BREA1H DUST, VAPOR,
MIST, GAS IX1 Kt-t-1' <:ONIAINI-H 12 O~f-1)
L Kl-t-1' AWAY 1-H!lM I-fl-Al
SPARKS ANO OPEN Fl.AMES C STORE IN TIGHTl y CLOSED
CONTAINERS C llt/Ntl\ :-ill/Ht"Nt-AH
COM~U!:1 f lijLJ::!:I C KEEP FROM CONTACT wmt
Cl OTHIN~ /\NO OTHFO
COMDU9TIDLC: MATCAW.9
~ EMPTY CONT I\INER MAY
CUNIAIN HALAHUUUS
nESIOUES L '-""'-U\t"LU:>r..JN·t't1VUI
EQUIPMENT
011-FR H4Nnt INr. .mn
STORAGE CONDtnONS-
Store In he orlfllnal conmlner preferably
In a locked i:IDrage area. Do not store
:. •• UH .. fll\,,I .. 1.-"" '4~ "'v11t.., .. :.,ut: .... ,
wllh olher peslcides, fettillzers, food or
food could occur.
PLEASE
NOTE -WAI0aJi111N0rmAm,11N, Inc b1!11vu /hQ/ m•mro1mg11on eno r1camm,naQt1CY1, conuam,a
h•r•tn /vicJurJ,ng dais and staWnBnll) ars
OOCl/fO/~ o; of lho <blo Mrcof NO W,1{){11NTY OF FITNESS FOR ANY PARTICULAR
PURPOSE, WARRANTYOF
MERCI/AW TA flt LI TY, OR ANY OTIIER
WARRANTY. FXPRF,"i:'inRtMPl!Fn.l,"iMAnF
CCWCERNING THE INFORM.~ non PROVIDED
HERE/II Thd,n/ormabonptCMdddhffdlnrlflato
MIY to the i~arir rtQr/~r, cei,cmtetJ w1amar notba V11/tl1»twa 1!.dlprodt£111uu<1in
r.nm{)Jn;v1m wtrn1111ynmn mnwt,-t, nttn;iny
1Iu1'Hi.,. h11U1H1. t.1t1:H 11~ 1,1u/iliu1~;..111I
m•llloa, atuu onrs pror1uc,snaor,n,
mtorma!on rolcffodtor-,rcv, ore /:>CJorlC/ I/Jo
L<•l•ul u/ Elf Alud.,111, 8/Alu11t,m e.,i.•1e»l1
w.<r.l,-X71~ a-11• 11ra 111 MbllllY ;,; tn anr t AFJl/1
aDt:JJned or 3/IS/flf'J /Jam a,y ~s o/t/111 procJJ:I
or tBlrercson wchmlormar,on
07-1~-93 08:56PM POD] tt21
)
.;·(NOX OUT'2FM
. . EMERGENCY
7CLCPI IONC NUNDCRG.
(401111111-onr.o (PRIMAf!Y)
(RM) 4?4-11:'lnO (CHFMTRFC)
PRODUCT
ID.NTIFICATION
PRODUCT
NAME
KNOX rnrr• :>FM INSFr.Tr.lOF
EPA REG. NO.
INSECTICIDE elf atochem MATERIAL
SAFFfY
DATA SHEET
ADDRESS: a.r ATOCI ICM NOFITI I MICAICAN, INC.
AOCHEM DIVISIOl4
THAFF PARKWAY
PHILADELPHIA, PA W11.12·
. Elli)
FOOM4827
REV. 12AJ2
SHIPPINO
INFOlf_MATION
FIREAND
IVCPLOSION DATA
PROl'f=R SHE'P/NQ
DE~PnON
RO FNVIRONMFITT Al I Y
HAZAnoous SU3STANCE,
LIQUID NOS (OIAZNON), 9,
FLASII POINT (TEST METT/00)
96 -C :!05 •F (TCC)
FLAMMABLE UNITS
'NA
REACTIVITY DA TA,
CONT1NUED
HAZARDOUS DECOMPOSIT10N
PRCIJUCTS. THERMAL AND
01HER:
P03SD.C TOJOO SU:JSTJWCCS met,!
11-EfN.Al DEGRAOA T1CN
~581-9:lS -499 · umo12. PG nt
a.r ATOCt Di Nam/ .AJIJ:1VCN,t INC
CODE NUIIJ9ER.
9180
CHEMICAL NAM!: AND
MOl.ECULAR FORMULA
0,0·DIEll-!Yl. b-(6-ME1l-!Yl·2·
(1 MCTI l'/LCTI IYL) ,I P'IRIMIOIN'o'L)
PHOSPHOROTHIQ6. TE
C..:11 11., N,U,l'::i
SYNONYMS
OIA71NON
CAS NUMBER
"HIF.
..,;/EM/CAL FAMILY.
OhOIINOf'HOSf'HA TF
HJ1ZARDOUS
INGREDIENTS·
MAT~ALS
DR COMPON9/T'S ~WW
DIAZINOO 23,0
r.nntahrtl ln pn>,,mrrlr mhnn111'il1r,
dispc1sad and suspended In waler
r,0ntarwnn 1111h.'llanr.r.ii ll'llnd 11,41
cdcby SM\/\ :n~ or ne S•• of Pecn-
i.y\r.lni:I, r.nnlaln.'I nn !\IID!\lanr.M knnwn
kl be ca1 dno<iens. ·
SARA TITLE Ill
RATINCS
IPPS"WM:iliflWI
n ... {u1111ulalt:t.l v1udu.:tl1111, 1,1 IJU~iliv•
• ._.i;,'ll f,,. Au,'" I J • .,.,...,J.
NFPARATINGS
Aammabllly: o
Reacllvlty: o.
Healdc I
m = rum AaaK.Jrn
NE= NOT ESTAOLISHED
PLACAROO
MBC. DANGCROUS GOODS
l',10: MARINE PO.LlJTANT
DOTRQ
ILB.
PHYSICAL
PROPERTIES
PHYSiCAL !UA1E
BOILING PO/NT,flANOE
ca 100-C
ca2t2 •F
MELTING POINT
NA
FRFF71Nt: POINT oac 32"f
MlXECUUR WEIGHT
(CALCULATED)
304.4 (ACTIVE INGRED.)
RPFr.iFlr. r.RAVlTY (H,n:tJ
1.041 0 20/20 CC
VAPOO PRESSURE (mm Hg)
NE
VAPOO DENSITY (Ar• 1)
NA
set.UBL/TY IN H,O
OISl'El16ES
" VOi.A T1LE BY VO#.UNE
NA
EVAPORATION RA TE
CETHER=l
~WA1ER=1 C t11.1T'r1.J\C~ATe=1
APPEARANCE AND CDOO nnor 1-101110-·
CHARACTERISTIC ODCfl
AUTOfGN/ llON TEMPERA 111REJ nm: POINT
UI\·
EXTTNGUISH/NG MEDIA
OOWAlER SPRAY ooonv CIIEM!CPL 00 WAlER FOO c Al.COIIOL
FO-'M Iii WAltH l>IHt:J>M 1'5<1no.
SPECIAL FIRE: F/GHnNG
PROCEDURE$
L DO NOT ENTER BUILDING C Al I oo FInF TO mmN .c WATER MAY CAUSE FFlOrnlNG
L UONOI U!;;l::VVAltH
Dij 'OTHER:
WEAR saF CONTANED
BREATHING APPARATUS AND
rnarccTIVC CLOTI IINC
UNUSUAL FIRE AND
EXPLOSION HAZARDS
-~ DLIDT CXf'LOfllON I IAZN"ID
E SCNSITIVC TO SI 100<
CONT..-.MINATION
TEMPERATURE
00 OTIICA.
POSSl3LE TOXIC
FUMES
REACTIVITY
DATA
STABILITY
OOSTABLE CLNSTABLE
CONDITIONS CONTRJRU11Na to WSTABIUTY
NA
INCOfolPA 11DILJTY-AVOID
CONTACT \Yin-I I 8 IH~l.i ACIUS C STRa-lG Al.KALIS C STRONG OXIDIZERS
00 OTHFAS:
MATERIALS THAT REACT
WO!IWATCR
Super 1Jser
CONDITIONS TO AVOV
l'5(J IICAT C orCN n.AMCS C SPARKS C IGNITIOO SOURCES
SPILL
OR LEAK mnemrrzwn
STEPS TO BE TAKEN
h= MA TEFNAL IS RELEASED
OIi SP/LLCD fa FLUSH WITH WATER
I:[ At:i::;UHl:I YVII H l:iANU I.IH
INERT MATERIAL C NEUTRALIZE
fZ SWEEP OR SCOOP UP AND
REMOVE C KEEP UPWND, EVACUATE
1:Nt.:LOStu !;;l'ACtS C rncvCNT spne,..o on SPILL
[: DISPCSE OF IMMEDIATRY,
WAB11: DfST'OS,',L NE1HOO:
Wastes restJting from die u.•e of dlls
prnduct moy be disposed of m1 sllo or
al••• Of-'1-'IUYOJ wo,.:,bJ),,3,pu.>al fcu,.:f:ly.
CO!IINUED ON Onl8l f;IDE
07-14-93 08:5~PM P002 tt21
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MATERIAL
SAFETY
DATA SHEET
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__ ..,.... ________ __,,,_.
IM'TcRIAL
· SAFETY
OATA SHEET
·-"'"· ---------------------------------------------
TOXICITY
OfW.(,actn"IIJ w.. <MTJ > a1.o»,....
.t:ICJMW. (Ac:vnlJ
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INHA1..AT10N(AQ/f'rfJ
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. HEALTH HAZARP INFORMATION
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THIii!!! ••"r<W&Y P),C11,>OEL,...1A, 1A ltl0Z
l'f'tOHJ!:
121S'l '"7•T6&7
HMIO fOLO\'lt mi,,
Cll"OI.YVIN'I\.~
mNioPPEN1 II 11VT"t1. l'IUINft aa *T\JfW. AUtee, a f'Q.VVINYt. AI.C0tO.
lllroLYffli£\.Etjf o~ a~,11
N!llf'W\4TOIITl'Jf'f-
~~ 0 ffl,l',eoNf.AIHED
CJ~D/.IR
.....
0 CAN Oft eunncGI OAS
Oft Vl>l'Qfll
0 "4.TEI\ CWT, RJMa. MIST
alJ 0™19': .
HOT ~111(0 -~ ta:>IW.lt s,.nrr~
crne ~n1crr.-. ·~ 0 IWJIB!ft IOOTS
0~
li!OtliE~ l'1'01'ECTIVE CLQT}41N(] W><ICH "1£V!NT3 SKIN COtCTACT.
$P'fiClAL
Pll~CAUTIOHS
~
IZ~Y~
aiSOOMOTGt;TIHrYa.ONSl'JN °" Q.Oni!NQ m, 00 ..or ~n. Ol.1$T, v~ '·Ml$T,QAS
al! l<tll" CONTAINER~
0 !<II' A/WAY~ Hl!AT
?AA!(I ~ Of'1N IIVJ,IE!
0 ~ IH 1'10)it\.1' ~OSl;'C CONT>JHtRS
0 00 NOTS'TCIU!: Hv.11 CCM8US'TIIUJ
0 Kif' Jl'IIOM COM'M;l' 'M1H CI.O™NG NCO OTHeR • COM9USl18\..E W.rout..S
liS 1/,Cl"tY COffT>JNER MAY
CONTAIN H~S AESlOUIS a U$£ ~ !OUll'MEHT
CJ 0'11-il!R
(ITHfl1f ~ AHO ~ ~
ST0N 1H THI(~ CQH1'AANM, ~TINA~~
APII.A.~INA~ WMIIIE...,.'Tv-i,r'ift ~nQH WffH OTl-1V' M!!SI~ ~ rooo °" FEEO CO\A.O OCOJI\.
Pl.EASE
NOTE • 11'e--.. _.•ID.,._ .,-~-----, ---~--...,..,,._,,.. _____ ,,,_,, ___ .,,.._.,._.., __
,.,,,.,_ ,;u_n ,,0 ..,._IT tJ'fHtilt f;la'..-.s:r o,, ,,_.,,o. --tVtr;r "'
,.,~ C:C,W~ OIi (!O,.rwc,,,4
l&C..-..,..;,,cr 01' 1)4( ~-C:,,,r.&~ ,.~/'&".&NO~--'"
C>4""'11'Y f'OA "~ :i-.,~o,, v-"""""'° ~ ,....,,.. 9\41,...""" ., ~ ~ ~ !O""' ~"""""
(
-·
•, ... -
PT 265 Knox Out 2FM
Pest Name
Ants
Carpenter Ants
Carpet Beetles
Cockroaches ....
Confused Flb~r Beetles
crickets
Fleas
Flies .
Granary Weevils
Red Flour Beetles
Rice Weevils
Sawtoothed Grain Beetles
Silverfish
Ticks ....
Warehouse Beetles ..... .
Approved Use Locations (use master char
10; 30; 60; 130; 140; 160; 180; 190; 2]
320; 360; 390; 410; 430; 460; 530; 570;
580
10; 30; 60; 130; 140; 160; 180; 190; 21
320; 360; 390; 410; 430; 460; 530; 570;
580
10; 30; 60; 130; 140; 160; 180; 190; 21
320; 390; 410; 430;, 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 21
320; 360; 390; 410; 430; 460; .530; 570;
580
10; 30; 60; 130; 140; 160; 180; 190; 21
320; 390; 410; 430; 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 21•
320; 360; 390; 410; 430; 460; 530; 570;
580
10; 20; 30; 60; 130; 140; 160; 180; 190,
210; 320; 360; 390; 410; 430; 460; 530;
570; 580
10; 30; 60; 130; 140; 160; 180; 190; 21(
320; 390; 410; 430; 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 21(
320; 390; 410; 430; 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 21(
320; 390; 410; 430; 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 210
320; 390; 410; 430;· 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 210
320; 390; 410; 430; 460; 530; 570; 580
10; 30; 60; 130; 140; 160; 180; 190; 2;1.0
32 0 ; 3 6 0 ; 3 9 0 ; 4 10 ; 4 3 0 ; 4 6 0 ; 5 3 0 ; 5 7 0 ;
580
10; 20; 30; 60; 130; 140; 160; 180; 190;
210; 320; 360; 390; 410; 430; 460; 530;
570; 580
lb; 30; 60; 130; 140; 160; 180; 190; 210
320; 390; 410; 430; 460; 530; 570; 580
... '-.> 'V
,.
Product Name: PT 265 .Knox Out 2FM
EPA Reg. No.: 4581-335-AA~499
EPA Est. No.: 4581-TX-1
Manufacturer: Whitmire Research Laboratories
Formulation: Liquid
-Does the manufact~rer of this product make its label and MSDS
available for distribution through PCT DATABASE? YES
---
II MANUFACTURER I s ADDRESS II
Whitmire Research Laboratories
3568 Tree Court Ind. Blvd.
St. Louis, MO 63122-6620
Phone: [314) 225-5371 6r (800) 325-3668
Fax: (314) 225-3739
IN THE EVENT OF AN EMERGENCY
Emergency Medical Treatment Action File Information
314-225-5371 (8 a.m. -p.rn. CST)
314-576-0120 (after hours emergency)
800-424-9300 (CHEMTREC)
or Call Your.Local Poison Control Center
Charac.t,eristics: Residual
State Approvals.: Alabama; Alaska; Arizona; Arkansas; California;' Colorado;
Connecticut; Delaware; District of Columbia; Florida;
Georgia; Hawaii; Idaho; Illinois; Indiana; Iowa; Kansas;
Kentucky; Louisiana; Maine; Maryland; Massachusetts;
Michigari; Minnesota; Mississippi; Missouri; Montana;
Nebraska; Nevada; New Hampshire; New Jersey; New Mexico;
New Yo.rk; Nor.th Carolina; North Dakota; Ohio; Oklahoma;
Oregon; Pennsylvania; Rhode Island; South Carolina;
South Dakota; Tennessee; Texas; Utah; Vermont; Virginia;
Washington; West Virginia; Wisconsin; Wyoming
C.hemical Makeup:
Chemical Name
diazinon
inert ingredients
Chemical Class
organophosphate
Toxic
Cat
III
Percen
23.00
77.00
-9 .l ' 1
(
\._ .. -
JI
,, ..
N09',c'T-•w• C01''TIIA~
:: ::., ·coNTRAC~
MATERIAL SAFETY DATA.SHEET
CNC'41CAL lo'01111.'-"'-1••-•I "•"'• • ......... '-.. C.JI.BrO, a.-..i..i...,.
ACT\¥. llioClla1&,n.
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NA S1i&htfy 1~thabl1 in •11u. NA NA
• IA'II IOC--1'4"""P'"v• I.Sitt
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I fll"U.lf IOVl'tO, fJl'llYt a tc~-:. g :: !:;.:--1 "-IU'I ......... A~ A•4 la a1 -• ·-•·-11 H!i.41. -0••
. N.,,. c...,.;.,.,
._.,,. IU,&.A,I ....
I • C.•uon: :),tap l,e imu1in1,
I" .. ·"· -·--"M l Maw~ ... doitin1 al,;l[r, ol cha !food and cau• l,l .. dln·1-
IMIICIAC'T na,t ,t,la rtOC:&•"ID
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11111•&1•111 A~ .. Vi.,._. K,.i--~.t, • ettillr • i_.-C,.., ia W.111, .... ~..,;. ............. i.,... ........ .,, \._. _ ....... -'""~ ......
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: . : Sf:CTlO!" L"(. Sl'£Ct.\l, rRF.CAUTIONS & STO~AGE OAT,\ or rROOUCT. .
,11u .. c1 nwu.rt.•• I "" ,.,, uuu L•h
Rcwan Wrt1fCnN~. Bad t. 11.aH:c Crw I miNl'l'Nm ol t ye., •hffl ,,....,.J prorc,ly.
11tlC'4L •• ,,..m .. ,n flllAI.U.C• .•o•n.•••
Avotd u1;•wrc let H&,ht and hwntdlry.
n U.:l...JhJ•I rd U 7u11 it h""•u--i;; 1111•• uouu;,.
A..,;,i lal.u, .,...,.. .,_p,,ndo.
,.o.,., .. .,""4,a.., ...
Con.me T2J'T.""LLJI tiaJ>1t,, ..... 1
Non-hu»d'n11
I •D '• '-" UU • .,LISI ..
Nnra ······"· '...... ·-·~·•
. CLoM
,.. ... .._,._,_. .... , ..... _ ... .,.,,,0-• ..... .,_~"---·'-'--·-............. t..t-..... ~-.. ---•• .... ..,.._..,_ ........... _ ........... .., ......... --,-.... i.--. .,._. .... ..,......, ... , n.._,__ ..... .,, ... ... ,_._. ....... .., __ ,. __ ,_.,... .. , .. ,,..,_.,, •. ,... ............... '-tu""""--~--·----... _•_-_. ___ ......,
...
••• PLEilSE PRINT OR TYPE AIL INFORMATION•••
--r-' -
Business Name: ~ ~ « tn \ l:::-l 1 ::&
Site Address: .:, ::), :;}, ( . L a ·, £ a L t'!:) A s \), \? • tl ('_
City: C: f\ e<.\ $. b f\ cl Zip Code: °\ :l, Q ~ q
The California Health & Safety Code, Division 20, Chapter 6.95, Section 25S0S(c) requires the following: .
A Business that handles huardous materials shall review~ certify their Hazardous Materials Business
Plan (IIMBP)· ~>nee every two years fro~ the date of acceptance by the County of San Diego, Hazardous
Materials Management Division (HMMD). The business is required to submit a copy of the changes to their
Business Plan and/or the certification to the HMMD.
TlllS IS TO CERTIFY THAT 11IE HMBP HAS BEEN REVIEWED. (Please check one of the following
boxes):
~ NO changes are required to the HMBP which was accepted on S-:-li -9 s-:
. (Date) D All the necessary changes/revisions have been made. The changes/revisions are attached to
this certification.
Note: The following changes must be submitted to the BMMD within 30 days of a change to the
Hazardous Materia& Business Plan:
• Substantial change iil the handler's operations which would require a change to the Hazardous
Materials Business Plan.
• A 100% or greater increase or decrease in tbe quantity of any hazardous materiai on the inventory.
• Additic;m or deletion of a hazardous material to the inventory.
• Changes in the storage, iocat~on, or use of hazardous materials.
• Any change in business name, ownership, or address.
• Any change in Emergency Coordinator/Contact information.
AS AN AUTHORIZED REPRESENTATIVE, I CERTIFY UNDER PENALTY OF LAW THAT I HAVE
PERSONALLY EXAMINED AND AM FAMILIAR WITH THE INFORMATION SUBMI'ITED AND
BELIEVE THE INFORMATION IS TRUE, ACCURATE, AND COMPLETE.
> ~~~-----=-=--. / . . ----=-./ ---... · 2;---
Print Name Signature
G I ~~ . \ ,, .
\: /SLf::'IC n J _. 6N A q.p8
Job Title I
y}13 / l Cf Cf=/
Date· '
Department of Environmental Health, Hazardous Material~ Mimageinent Division, P.O. Box 85261, San Diego, CA, 92186-5261
Distribution:
DEH:HM-9218 (2/95) (NCR)
-1619) 338-2222
White~Retum to HMMD
Yellow-Business Retains
POOR
QUALITY
ORIGINAL S
THE 'l' Erfr1 HH X U·I'.1.' E:HM !\'L' l_l li-l i\ 1 .. , <.) .it·ff Ml'.i'. L,. I:'.' •
:2:::2.1. L,AS PI\L,1-lr'\:-: iAL . "i __ '.'
"1'"" , .. ,,-. ···-.. -t:1\.,J·-l¼_, H~• -· i I l•,t:,
PLAN PR8:f'1\REP BY: LEE ZUSMAN
626 PORTERO AVENUE
SAN F.l{ANCISCO, CA. 94110
(415)282-3432
i.J p fi:i\.i\ '"l_'_t _:].-~
On-s :t te ma.n,:1ge1·:
On-site alternativR:
Regional Technical
Specj_aJlst:
SeEi a t:,tached invento.ry to1:·m:,;.
t·itJ.lTFJ CA'..i.'J.i.lN FLAM
·7/,-.. •·:in •7·~1~·=-t::e...1-~~--•(' ~-I _~, >
qoq-~.,--; -13,1
( WI·-I
1 hJrr i
7li,0-.1::!1:'··-T/t=;n ( wk i
7"0-~~(-li~L/ (hill)
i3.H:l-'.-~!-3o·--:33'.>l , wk)
61 l?,-229-1128 [ h111 l
ln the event~ of B th-ret.it.,,nv::•d <Yr· ;:H:t,111:1.J. ernergenc:y :=:i.tur1t.i,.)11.. the
die:cover·er 1nust notify t.he on-i':'.i te 11H'U-lf.1ger· tkeou.gh the u:::::e uf r.he
local communication/alarm sys te·tn.
The on-site manager sf.vd 1:
l. Notify a.11 per-sonnel ( ernp.toyet:.!E_; and visit.ors\ t-,h1:t.t ci.n
emergency exists. This ls done by voi~e. All personnel
shall be evacua.ted in accordanee with t.he Evacuat.ion Plan.
unlees the on-site menagEn' det,ernii.nee tb;,.t, evF1.cu0t. j on L:.: not-,
needed (fo.r--irte:t.a.noe, in t:l-ie event. o-f a f:H1v=:dl spill)~
..., ,~. Notify the San Dlego County Dep-:1.rtm':!nt of Hi=:~a1 th s,~r·vice.~ •
Ha:r.ardou_s l·1a.terlals Di.vtsioH by cJj_rJl "illfi r3U-)--2~·:H3-~2:2:~:
3. Notify t.he Stat~ Off j_cF: of .E1nerg,=.i1wy ;-:,-,.,-.--1d.c:!':!/:: by di 1:l .!. .in&-: 1-
R00-852-7550 or l-OlG-427-4341:
4.. Notify the mimic:j_pt-1.l fi.-r:e dep,jr-t:.m8rd.. j n t.hi=: ev-"'·!1 ~-· r,f
thr-~F.1.tened fire or-exr.,l.o:=:; i.rYri. by di_-9.lit,g JJ. :1 :
i--• • .I • Not if.v the Ter-mhd.x RP-1;,.ionr:1. l '.l'eciin.lc:a 1. :31=-,ec .Lo 1 ir:; t. hy di..~, l in1~·
619--268-313~~4;
6. Notify lndu.f::try .r-er:pon.t=:1r;• <":(10i:d. i. 11,'-i t. ion
if neces:::1ar·y tei r1~1:::pond i;u ~ J ;:;-i:·g,··
diallug 1-B00-424-9300.
v i .. r:1 CHEMTREG,
• 1r: r-<:-! 1.e.:::iBe by
Jt. i:s the .int:i=:nt. of Ti=:r.·inin:b-: lot:.•0,.1-:rir:d.i,,r.;;;! 1-·'·' 1.-,kp r1.ll ar~tion
nec:essar·y to p:t•ev.ent tlie oc<::U'l'·r·e11ce ,Yr_ ,3 f i. (·~ -.1-:? 1 • I osi.rJn. 8Pi 11,
Telea:=-;e. et.c.. ThlB fr1c.i.llt_\-' r;_,J_Ju1,c,:; ,-,::-==:;:-,-=:,,.·,1,u i:.•oli.r-j~c:.-and
procedures tha.t st.t'ei::,8 pt:i?.'.'·~nt: iJ,n ot e111.:::r·&-':'nc:y . ;_i_tuatic:t;; ~n;.l
rP.g_uire strict compliancr--wit.h i':tppJ.i,::Bb:-= ::'.°<?---it0·r·.·,t, 8 te.te. and
loc:al regulations as well F.1.r:; Gor-~·cit·at.e S;:!r"-':'-.? -=1r11l Loss Cm-i-tr-ol
Pro1~'.edur·es.
Pr·evention ac:t.ivities i.ric:l.uds-bit·'. r-:i,·~:· n,.,i·
1. Complian.c•?. with al.1. st~t:.e r-:,.nd Jc::::a.L :fi.:··e ,::c·:l1::;·:;
.-. ,:.; . Isolated, fi;r•e
ventilation;
. t. -resi:::: .. ive c herr,-i r:.,J. J.
3. Maintaining t.he minirumn amouni,, of che,r1:I :::::;. :_ Lnvent.or·y in t.hs·
fac'ili ty necessary to perfor·m off-si tr:· .s,-=.:r-v icr,·:,:;
4. Rest.rict.ing the use of <::ont~-d.ne-1· fli.'::;f:. -:-.,·· H!°' l:1r.·ger t;han five
(5) gallons. excep~ fo~ £wnigents:
5. Ma"intaining emergency e,;,iu .. iJ:,111ei-i-t, i.n i~he ::-::~.:= i. l j ty-:
6.
7.
Following proper hou:=:.:ek.eepir,g
pose~bility of fire:
:3trict compliance
storing. handJ.:in,g.
t .... ·:i. t.11 p1·od,Jc:'::
u-r d :i. ::.:poeiti!?. o-f A
t: .-.1 ud.n ind ze the
,-.-.. --.-.. -.. , ,-. ,. .. _ ... -----· -·-· -
when
13. T:r·eJ.ning of al:l eni_~,J.oyi::-ei=: in i:·,-,·: 1:,--=--~--'' t-•"Jl"r.1.~e. hti.ncll ing.
applying, ,'3.nd dispoc:1Jl pt.·oc!-Jdt.: L·F~.<:::
!:?. Regular fe.cility lr1i:q:.•ec:::t.t,-,nt.: ,·,y fri•:·i. i ::-:.:.:. 1·ep i.ori. di.vi:::j_on-
0::1.nd co.rpor-<B.te :pe1··sonnel ~
10.
11..
Regular equ.tpH1ent
pr·ogra1ne: ~
Inspections by the roun:i.ci p:~, i.
appropriate Agencies.
In thA event; of a t.hr·er.t t.encd •:it: ::ic t.11_;1 .i. en1er·gE·nc:,.,.-:=:-: i. l:.LH,1.t, i.on. l..h>?
d.i.f:coverer rimst notify t.he cm-1:;.Lt.1:· ur;H,;_=J:?,t=:r· tln:·ouglt t.hr-1_1_::;:r,: of the
local et1mmunic::e.t,ion/ala.1·m :=::y:"'lt,,::?111.
The on-site manager shall no-Lify all
visitors) that an ~merge11,:-;y e;.~i:~:t.t=s.
All personnel shall be e·-r::-1c1J1:1t.ed
Evacuation Plan. unless the on~sit~
evacuation is not needed ( for' in~:t·enc;e.
spill):.
J;t8r::c:c,.unel ( f::'tnr,loyeP.i:: and
Thie :i.F: dune by voice.
in aecor·di:1.ace with th!':'
H1-"1.na.ger flet.eru1ine::-1 that
i..n t.hP. event. oi: · a e:mall
The Evacuation Plan shall b17-pcn'::t.ed· Ln thE: f0.,::;Llity wher·8 it. can
be easily viewed by e.:I.J. employee:-=.:;. Al.l 1:'!1nployees must be
thoroughly traine~ in evacuation procedures 8rui evacuation drills
must he held at leaE:t twice e,::ich · yeBr-.
The .Evacuation Plan shall he reviewed l:l.tv5 .i.n1.medi::.:i.tely revi.:.=;ed, if
necessary, whenever:
1. The Plan
emergency;
fail:~: Ju.ring ,:,.n !'~V[1c,un.L.ion '.Jril.L or <c'l!;tu.a.l
2. The :facility design cl1t,:l.n~e3 in a l!t-':lnne-r· t.liat. af fer_· l..s tbe
--?-vacuat:ion routes or r1:,qui.rE-n1en1·,:::; ,·i'f !:.11e Fl":.lri:
:3 _ Emerger1c:y -e,;,ruiprner1 t is r.1.1Jded.. cJt-:!let.eci.. c,r· r·e l<JCr:tteri.
FACILITY THATNtlv; t'Ll\N
A 11 new employees whq work with hc::-t.zardouE:.: tnaterir.1. l.:=; rt?.cei VP.
training· in acco-r,dance with the Federa 1. Employee Rig·ht-To-Know
Law (29 CFR). New· employees ar-e also trained in the safe
handling, mixing, us~. storege. and disposal of hazardouR
materials by compl-et ing Term:i.n ix·· in--houe:e Anchorman o.nd/or
Keyman Basic Training P1:.··ogram:=; ·within th.E· firf:t six weeks of
ernploymel'tt.
New emr .. loyees w.ho wo.rk with hazardoiJ.:=:, 111r;i.i.,~ria.ls at·e ,::_1} sc• r-c-::qu Lred
to sit for and Pass the Californj4 Str~ctu~al Pe5t Control Board
Certified Applica.tor Ext:i.mina.t.ion a.nd/or-the Field R.r:n::•rr::se-nt,':t.tlve
License Examination. In order-to paas t.hese ezamina.tions the rv::w
employee mue;t demonstrate knowledge in the s,:1.fe hand l.ing" mi:·:.tug,
use. storage, and disposal of ha~ardous materials as well es the
use and maintenance of pe1:.-sonr:1 l. protec· t. ion. eq:uJ.r,ment.
Feder-al, state, and local 1·e~Ti.lat.ions e:over·ing t,he use of the
hazal'.·dous tna:terials that the t1ew employee will be working with
ar·e reviewed in training meet.ings conducted by the on-site
manager and/o~ the Regional Techriical Specialist.
A 11 new emp1oyees who work wi.th }1a:;:~al'clous mater·ials are tr·ained
to bi':: pr·ofieient. in· the TE:,.r·rninix Spill Control Pr·ogram. The
basic ·elements of this program are: (1)· containment; (2)
notificatton: (3) cLsa.n-up; and (4) d.i.sposal. Emphasis is ·also
placed on tht=: use of protective equipment and rest:r·aining
unauthorized personnel from e:ntering the aff~cted_ area.
New on-site mKnagera rrrust have completed all of the above
tr·ai.ning before being placed iri ·r.;har·ge of the facility. During
the new on--si te 111a.nageri::; or·i.0:itta tion, the aspects of this
Haza:r:·dou~; Hate.cials Business Plan, the location of the hazar·dous
·111oter-i.al~1 storag~ are.a. and the location of all emer·gency
equipment (:r'ee:ptrator::;, p1•otec:tive cJ.othing, spill control kits,
etc.) are reviewed with the Regional Tedhnical Specialist.
All employee~ who work wi~h hazardous mAterials receive on-going
1.1'aining·. Th:it-; is e.eeomplie;hed by the Te1:n1inix ,Pesticide of the
t·k1r1th Pr·og1·an1 as well as by on-t.he-,iob training conducted by the
on-site 11°10.rH:!.ger~;; arid the R,::ftioI·L.-:t l T1::,c:hr1ical Specialist.
Additional]y. all licensed em~l0yees
St rue tu:r-a l Pest Contl'O l Boa1·1l approved
courses in o:cder· to renew their:· J.ieern:;es.
must complete state
c.:ontinuing education
At least once each year th~ Regional Technical Specialist reviews
t.he a.spee;ts of the Hazardous Materials Business Plan with the on-
site n~nagev. During thi.s review the facility is inspected for
OSHA and EPA co1!'1pliance.
At least twice each year· the Rag~anal Technical Specialist
eor1due;ts mocK. r·e te·e.aes and evaluates the on-site managers
performance ilY containirtg the-r·elease, conducting the evacuation.
and t.he rna.nnf::Jr in which he or· she would report. the re lease to the
ontho·e i ties.
FAGILIT\' El:-1ERGENCY EQUIPMENT
The neceesa-r:·y emergency equ:i.pm,::nt for· th1s facility is compeised
of fire extingtiishers" spilJ control kits. and telephones. The
loco.l:.ion o.f t1i:i s equipwent i.:: rioted on th~ facility map.
Addition~lly, all emergency contacts mhintain personal protection
egui.p,nent. (goggle:::;. 1·espt·r·at,:,r·e. pr:·ote::,t i ve clothing) on t.heir·
vehicl.;:s.
OTHER EMERGEHCY G(HlTAGT:"3
If the on-site ma.n:=:,.ger· dP.ter·mines tho.t. the t>wili.ty haei ha.d. nn
emergency which could thrQate11. hurn,':l.n. heal th or the environment,
outside· the faoility., he or she mue:t i1runecUately notify t.he pre-
designated, industry on-eicene coor·dinatol'.· for the area. by dialing
1-800-424-8802. This report must include the re:i;.,orter ~ s nami=:.
telephone t1umber, name and c1.ddr·ess of the facd.lti.,y. name a.nd
quantity of materials involved. e.:K'ten t of in,iu.rieE: ( if any). and
possible haza1··ds t.o hurne.n her:1lth And the envlronm~nt. . 01..1t.e:id.e thr:
facility.
Medical assists.nee, if need8d. wil 1. h!:, requested by dialing 8.U ..
Additionally. the foll.owing f,:1cd,lit.y or fr11.:.iU.t,i.e2-w.i.11 be u:-:H~d:
Tri-City Urgent· Care
2095 W. Vista Way, Suite 11n
Vist.a
619-84.0-2011
In t.he event of a threr.1.tened o.r r.1.ctue.l emet'g·~n,:·y si.t.u,:11;i,:•n. the
discoverer urn.st noti.fy the on-;::: j_ t.e rn,;1n,:=,ge1:: t.hrnngh thP us,:o, o:f th!::'
local communica.tion/ala't. .. !It B:\.'!"l ti==:-111.
The on-sj_te manage:r· slvdl:
1. Hotify al-1 per-sonnel (i:;:mployeee end. '-'i::=-d.tc,:rr-:;i that r.:1rt
erne1: .. gency exists. This it: done by vo i. c-e. All f.•erso:nne l
shall be evacuated in acc-ordance with the Evacu':l.tion Plan.
UnJ:eeS t,he On-Site tnF.1.tV:t.g'81': d.et.!-:'r"lfltrief.i t.11!;1,'f', ~Vo.(:'l.lo. t, iO ii _L;:::
not need.eel (.for· inst.at,ee. in ·the event of r:i ::::1w3.1.l i:::pi.J.J )~
2. Notify the San Diego County Dep-3.l't.men+. of He-=tl.th Servicef.-:,
Haza.rdous MateriaJ s Pi v isio11 by di-:.,.1 int{ 619-23f;-222::;
3. Notify the · State Office of El'iH::,:!':·gency :3ervi.ces by d.ta.l.i.ng l-
80i)-852-15E,O or-1-91£3-4::::7-,i:34:l.:
4. Notify the llllU1,iGiI,1r::l' Li.:t·e dF·p:::;,i:·t·,rr11:•n1". Ln r.h!"-r.a,,'::'nl, c•C
t.ln·eat.ene,:J f lre o:r-e-;.;pJ oi::•ior• by di al i.t,2 ·.J:l..!:
5. Notify the Termini:•: Regiona J. Te::hni<:.:1:1 l Spec:: i::1 l i.~:t h~r d iaJ. ing
619-268-2,824.;
6. Notify industry responee co1,r·din;:1t~ion ti::>c.1!12'. via 1.'.HEMTEEC-:.
if necessary to ~espond to R lorg~ spill or ~0lease by
dial :i.ng 1-800-424-8301·1:
7. Determine the t;y:pe of chemJ.c:td:::; invo lvi:·d <:1.ni:.i. the ext.ent. cif
any hazard or threat; posed by thr:: el-r·c:1.11n::-;t..,:n1c:,~s;
8. Ef:timate the extenL o:C 1-•ussH.1 li:: iiAzard.s t.o huinon health
or the env ironmen.t, c-onsiderlng 1io t.h t.Ji rect r.1.nd {ud.j_r·ec;t,
effects of fir·e~ exp.1.oi:c:ionE:, ,:,r· l:':t•.i}'.l::;.
In the event of
per·sonnel shall
E:lu:mt warnings
summon or alert
an emergency, intern-':l.l cornmuttic:atior,~: f..o fHci 1..i t-,y
be by voice. .AlJ. employees Rh-:1.J.l b8 h·F.J.ined t,o
i1umed.1ate1y to ot-,her.-F.·mployee:=; in t~h!--" r.:1.ree and. to
the on-f::i_t,,.3 1111:rtF:1.§/er by Wf-3.·Y· t.1f voi,:-:r~ c·on1!llrJt1dF.:,.
Exter·nal communic:atiorH'-.; i:.;:h,::!.ll 11P rnade hy tel"::'J;•hc•ne. All
employees ::::hall be t. t'ained in . 1:i111erg81H:;y r·8sponse p:r··,:,,~:edur":'s.
inolu.ding reporting to li::ic:al r.1u.!:.ht.:".1ri t i'?.:"-j. Emergenc·y number.·f:.:
sht1.ll be posted in the fac.i..li-J-,y -3nd. ol.:.ic'?.d on 1:>r 1v=:;-:n· -i·.Plei:•b<.Hi·:>e.
Clean-u.p efforts she.1.J. begin icnmed.i·0tf.": Ly. :31.v:-b effr:,,t·t.~; sho.l.l bi:·
determined by the t:auee 1:ind n,:"i.tux-~ .of thF: lttc iden t:.. In t-,he evs·n t.
of a spill or release 0£ che11.1i-?e J.. 1-•ro,;cd.u.res ou.tl Ln1:::d i.n t,h·?.
Te ri:nJ.nix Sp Ll 1 Contr·o 1 Pl''r:)9.:r-:::=:.111 f:h;:1 1. l 1v?. j mp Lem,:-~n ted. '.: 1,::-.-=n1-ui::-
shall be performed in act.::or-danc-r=:. w 1.th dir-ec t i.on.1:.: :J::"-r-,-,m Lhe i:-r,:idu.,:· t
manufacturer·. All cle,:1n-up T-1.ct.ivi t.i,:~t:: shnlJ be· coor·di11, . .tted wj th.
and appr·oved by federe.l. e:te.te. A.nd loc:e_j_ a.1J t_ i-1ori·L t,:;:.r::.
The on-site manager-shall i:1.le:o coor·rl.in,::-1!.e c:J.e.=i.n-up Hct,i.vit.i..ef_:
w11.;n the R.!;!gj_onal ·Technical :-3!".•e,::ialir.;.;t. 0w.l Gor·pr,r-1):I·,.=:: Fisk
Management Department in i1ernph i.r-;;. T0nrH:·::::i:-;e,::.
If the on-site manage1~ deter-n:d.n•0:r::: th.,"J.t. t1v::: !'.actl i..ty hr:i:::: had an
emergency which could thre0.t.en }LU.Jrr!).tt bea.lt.h or t;h!c: P.nvJY·ornne1rt,
outside the facility, he or:' .-=:he tIIIJ.EJl~ immer.Li.a t.eJ;1,,:
l. Notify the -local B.ur.ho:r·lt.i.~;:-;: t.f1<:1.t. ev1.:i.cua.tion of near·hy
personnel may be needed. F.1J1d stanr.l b:., to a:--:Gi.:::0 t. l,hor~ ...
authorities;
:.~. No·tify the pre-desif;rv3.tecl~ irtclu$tr·y on-E~csane c<JC)1·clit1r..1.tJc.1r· for·
the ,:1.rea by dialing 1-l:W0-424-1380::.::. Thi~;; repc•r-L iflUBt
inolu.de the rep1:-;rt.er·Ji::: narn,~~-t:::lephone n-uii1ber. name -::1.n,:l
address of the fa.ciJ..lt.y. name and quantit~, of rnateri;jJ.f:;
involved. extent oC iri;iu-i·ies (if rJrtY.i--::inr.i por:.:f:iibL':" h,:1z.a.rd2;
t.,~, hu.1nan health and U1.;:· env.i.:r·o11H11-c·r,~. out.:=::Ld.+::· t)1e fr1•~:i .i.tt,:-'.
The Cl!1--,=.•J' r P. ·1n"'nao·c.1·• -=-:'na· lJ' i'.t.J1_,-;r, ,;, 1·t 1' t· 'L-"• J-,::. r•r-,crnn1·,c;,:. ·t,,·, /J· i)r-:! ~~l(tPt··GfPc·1c•y i..1.--;.j.~_,. ;_,, t=,'-• • ..., -• • ._ •• _# •..J ... ••.r ,_,.i..t---LI.,. ,_. I,•-•' -• ,__.,_. •'•
in eccordance with 'fet·minl:·: lrtLf.:.'t:-rwtion:::i.1 'c, :-3pi..J.1 1.::011t.t·oi
Program.
In the event qf fires or ez.plosion.-1, th•? on-si:t..e_ manager r::ba.l 1
assist local authorit,iee: ar-j rnrJ.y be needed. He or t::he 8ht:t1..l c:1.le:o
ensure that all hazards have beAn eliminated prio~ to resuming
OJ;>er-ations, ensur·P-t.hat. 1:1 l 1 debt:· i.r:: L::.! pr·ope't:· J.y iiflndled fol:·
d.ie:posal, 0.nd. no'tify the ;=;1_.13_1'.e Office uf. J(111P,t·gelK:Y SF:r·vices prior
to r·esu.ming ·operations. £\ r-e<:ord ,_, f the incident sha.1.1 00 p l.;J.ced
in the facility~s ope:t:·r.1.tjng r·ec-ord -"Ind •withi.n Hi day::-; c,£ t,he
incident, a writ.ten report .=::hr.:-d.l ly=.: c:ubinit.t',ed Lo t.he f::t.;;:i.t.e l)fflce
of Emergency S~rvices.
If the emergency si..t.n8.t1.on involve:~: response from outside
agencies (:fire. police, f:;_piJ.l re:::::i;:,onse units. etc.). c:lea.n--i:q:,
act~vities shall be coordinated with respo10ing Bgencies. The
on-site· 1c1ane.ger shall pt·o,,·id.f:.~ r:e·.,tl.leGted i..nfor·tnt1 t i..<.:in i:·c•nc:e·cn.Lng
chemica.ls involved and necesea~·:,,1 clean-Dr, ~t·:.:ti,:11-u::: to r.he
respor1d.ing ageneies.
I
-~
1 l
1 .
1 ,. :! i! ij
I ~
Tt:tomas Bros.
Coordinates
HAZARDOUS MATERIALS MANAGEMENT.· DIVISION
\9_\=c.. 31TE MAP ·
. .
Business Name \e..R1Y\tf,.,)\,c ~-r~A-T'lco;.,.y,.. Co : ~l>. Emergency Coordinator· . 'De.&...-"B\,)~(?.\f)~S
H ,
Business Address ?ac.\ LAS PAiY:1AS J>t, 'S"re.. Ci CAl?§t5AD . I . Phone Number • Day ·4$~ -,, pS 24 hr/home . =
1
hf
I
(;11_ Lfd,' " -~ Appttov. .)
~8,
L"' 5 ~A Uttlir s
c;~,) ~<--,
. . ~~ ., . -4~ ..
_J<;
' '"J:)n.,u~
(Sf2.eet.) ~(.. \
_ .. DR.\ ~i:•""-'/It'{.~; N""
.&.r---~Gi~~-~~-:::T:--~----____:~-
& ' ~~ ~ 6{(,""--1 I 1-r::r----""r22a i !;R-:>1,Qcr
1 A~B ,_, 1'<-, ~4,t.~S. t
~ w
~ & A
0F~1c• i t. ~~
-{ Qf?.f;f,ft,t
rr-~,c.-e. ..
1)
E -::t.
v:,;..Q :
-~j .......
I I I
5l :1
Q)
? -~ c!J ~ -., i · . a!
' A ~t--:--_.i.._---;---L---__________ _
~\~ ~ /-:PA-R.\'-tt.)~
-r-
-
·,
I
tj z ~
8J &
cJ
~ DISTRIBUTION: WHITE-RETURN TO HMMO
DHS:HM-952110/911 YELLOW-BUSINESS AETAHS
~r~~.reecr
21 County of Swl Diaoo
p.....,mwit af Health s.,.,;...,.
-· )~3/ 16/ 1995 05: 4 7 6194806246 HAVNAL&CO
Title 24-Report for:
Termlnex
2221 Laa Ptlmaa Drive
Carlsbad, CA 92009
Project Designer:
Progressive Electric
3679 Camino MJrgten
Escondido. CA 92025 .
760-741-1583
Report P.repared By:
Mark Gallant
HAYNAL&CO.
425·W. &TH AVE., #201
ESCONDIDO, CA ·92025
(780)743~8
Job Number:
Date:
11/18/91
PAGE 02
The 4;nergyPro computer program has been uNd to pe,fonn the calculltlOnl t\lfflMllflHd In thll c:iompli.nc-raport. Thi. pr09ram hH approval and i
authorized by the California Energy Commission for use with both the R9lldentlel and Nonrealdentlll 1995 Building EmHgy Efficiency Standards.
Thi. pn,gram d4Mlloped by Oablf OoddlEMlgySaft. lie (41 &) 88MVQO.
UUr Number: .. 31
NOV-iG-1998 14:14 6194806246
03/16/1995 05:47 6194806246 HAYNAL&CO
TABLE OF ( 0!\P f--N r<--: ~: OR . 1 ft F >/i pr·pof-?.T
Cover Page
Table of Contents
Form. L TG-1 Lighting Certificate of Compliance
Form L TG-2 Prescriptive Lighting Compliance Summary
Form L TG-MM Lighting Mandatory Measures
Nov~1a-199s 14:14 • • • ·• • : • r '• ~ 6194806246 94%
PAGE 03
1
2
3
5
6
Vfff Numbtr: .. u
P.03
03/16/1995 05:47 6194806246 HAYNAL&CO PAGE 04
CERTIFICATE OF COMP! !AN1 ·r l :iiht11111 , · 1 LTG-1
!PROJECT NAME _____ ·-------. ·----. --------------~----.. -·----_ ........ ,------------?
l Tarminex 11/16/98 1PROJ'EC't"AODREU-:-·------------------------------+-----...,......---1
1 · 2221 Las Palma• Drive Carl•bad
-P'R'INCIP'ltl:'1'ESIGNER ~ (IGRTINtJ --------------7Tl!l:INM!,------j·_· .. : ::~·~:::.· ·. ·.
DOtlJM!NTATtoffA\lTR'OW" _____ ... -
: HAYt4AL&CO.
3,700tq.l'I.
lau1L01No TYPf ..,,.l~.,,...·-"_o_NlltUIOEHTIA ____ L..,......_D __ HIOtt __ -_-_•_-_•_· _TW. ____ o ___ _
,PHASE OF CONSTRUCTION I~ NEWCONl1'RUCTION O _AIXJITION :o ALT!RATION D EXISTING+ ADDITION ·------·· (1 __ c_OM_P_L_m_au·-,-LD1-NO--~-=-----M1A-~CA-T1~GOR--Y-O_t_f\l_LC_R1D __ ----------
• ,s e I ca e o omp ance 1s s e u ng -"" • . ~ -~~>n• n comp y wi
rarts 1 and 6 of the· California-Code of R~. Thlt c:ef1111catit applltt only to·bulJdlng lighting requirements.
!
Jrhe documentation preparer hereby certlfln that the document II ec:=cume· .-d complete.
i
~-OCDMIJITAltON AUTfl · DA
-:Mark Gallant ---'-'-------4'-'--'.-....<---,.;-----/(:lb·~,. iThctPri~cipal Lighting Oesigne~ hereby cert-tt,at the propoMd buU ng detlgn repNIMnted In thla set of construction
·,documents is consistent with the ottler .complfenc.formt and worklhHft, with the 1pec;ricltlons, end with any other
calculations S\lbmitted with this permit application. The f>ropc,Hd bulldtn9 ha been dellv"ed to meet the lighting
Irequiremenw contained in Sedion, 110, 119, 130through 132, .and 148 or 149.
I
!Please check one:
] ! · -! I hereby affirm that I am eligibhJunder the-provfliona. of Olvfllon 3 of tb*'Bull.,...-Ind Prafelalon1 Code to sign thla
j · .. ' document as the person respQnSlbte for lt1I preparation: and that I am • dvll engineer, electrical engineer or architect.
i i .
I ~-~ I affirm thatl em eligible undtr the exemption to Dtvltlon 3 of-theBu,lntti.and Ptarulion, Code by Section 5537 .2 of
1 "µ., th• Business and Professions Code to .i;n thfl doeument 81 the peraon relPOf1llbfe for Its preparation; and that I am a
, licensed contractor preparing documentt for work that I have .contracted to~-
I · ··1 r affirm that I am eligible under the exemption to Dlvt111on3 of lhe 8Ullnlla and Ptortttlont Code by Section ___ _
·--of m, ____ ~..,....,.,.-------Code to a1gn thl• documei,t • the peraon reaponalble for Its preparation; and for the following reason: ___ -.,.... ____________________ _
IPlllNClPJiL Cl~1'ESIGN!it. RIME
' . ~ .... , . ~
or-detailed instruction& on the use of th11 and a ne,gy cy le lfda com
Nonresidential Manual published by the California Energy Commiislon..
.LTG-1; Required on plans for all submittal&. Part 2 may be Incorporated .tn 1c:hedufti on plana.
L TG-2: R•quirad on all submittals. ·
LTG-3: Optional. use only if lighting·control credltl are i.t<en. . ' --~~~--4'. __ ~ptional. Ua~-~nly I~ Tailored rMlhod la uted. Parts 2 Ind 3 UHd only lf appUcable.
~ 1,0 Sy~M(ffSofr IJwflutnber 4112 JollNc/mber.
:. --···--· .. ··---------·-----. --------------------•·· PaQIIJ:loft I --··-·-· .... -·--------·
NOV-16-1998 14:15 6194806246 94% P.04
03/16/1995 ~5:47 6194806246 HAYNAL&CO PAGE 05
CERTIFICATE OF COMP! fAN< ~f--t tqhti, ,, ; P q, 2 o! 2 L TG-1
1:RoJECf NAME • . Te.mun•)(
INSTALLED LIGH1 ING SCHfOlJLL
LUMINAIRE
DESCRIPTIQN
rsw ~nnd lncandt9cent
'3) 4 ft FluoM~nt T12 ES (Tandem) llagEE
.
CONTROL:LOCATION
(Room#)
CONTROL IDENTIFICATION
CONTROL LOCA llON CONTROL (Room # OR Dwg. #) IDENTIFICATION
I • •
.
NOV-16-1998 14:1$
::
LAMPI
NO.OF ~ DEIKINATION LAMPI
71W 1
F40T1IIEI s
. CONTROL TYPE
(Auto~ "'*'h. Extfrlor, •·>
..
CONTROL TYPE (Occup,nt. ~lltht, Dimming, etc.)
' . . . ..
. :. :{·. :,.·: .
6194806246
71
M
lme 11/16/98
.... n:t
QEICIUll'TION NO.
NollallMt
·-Entt'IW Efflcfllfll u
.· •.'.
:-. . ., ~-
-.·. -:· ....
-···. ,· ... , .·
SPACI CONTROLLED
. . . .. :
··-. , .. _, . ,· _:
:.·. :. ·:.·:~/ ._;
LUMINAIRE CONTROLLED
TTPE #L~MIN FIEJ;O
.. . ',
... _ ...... _ ..
. ::::_-~{f;_/ ·,'}t .·
.., .
94¼ P.05
03/16/1995 05:47 6194806246 HAYNAL&CO PAGE 06
LIGHTING COMPLrANCF SUMMARY L TG-2
!P~OJ~CT~~~i~_-·;_~_-in_··-._X_---_··-~~ ........ -_________________ __._~ATE 11~16/9& --]
i ·,: . L·u:,:jiui-] ~ .. -·-·.... .. DESCRIPTION I : ·-·· --··· ·-··1 3):4 tn=ruoiNci""'m-u ..... 1-n..,, ..... findiriia::a::::a::=,.,,lliil""'_ -1·~
·j · ·· · ··-, sw Ricniid lricindiicirit -~---
-I · I . . ----.t i ······--···-·-·-···----~------. ! r i
1 I · ······ .1--~:~ _-:~=----
1 ~ ····---·· ·I···-·· ·----------· iJ ·-.. ·---. · i· ··-----·-. ! I ·-·----_., •.. -·-···------··---
l [ -----~-· __ ·.:·1,· ~~-==: .. -·-------!
; I ... --. . .. -· --------.. -. _________ ,..
NUMllllO,
UIIIINAIRD
40
2
._.. .........
I
I! .. ·!~ "~-~~-~V th__!~!~ o.tautt ~··· p ..... pnwlde suppotttno ~
I ---------------
: I . ······-·· ••..• -·-·--·-··----· , 8UIL,QING CATEGORY (From T_,.1-N) '. [omte . ----·-·· ..
: I
J L-------.. -···--------
f WAffl PER L,_IRE CIC lii,FAiii;'
(tncludlng Nnt) L!J!!"J 1oa.o ~D
. 75.~_ !~[]
r-·1r-.. __ J
[lr~J
[JLJ
0[]
[JD
[JC
[][_;
0[] ..
TOTAL .. --]
WATTS
4,320
150
!-·--. ---1
PAGETOTAL i--4,47~
BUILDING TOTAL [ __ ~~
LEIS CONTROL CREDIT WATTS I nl
(FROMLTCW) ~-------~!
WATT8
PERIF
1.60
AREA
(SF)
3,700
A(LOWED
WATTS
5,920
: I I! .......... ----·· ··--·-·------------------------1 -----l t=_
I
[____ . ---
;TAILORED METHOO.
;=:::==::-:::::::::::;
PAGI TOTAL I 3:Tog L... 5,920]
autLOINo TOTAL [ 3,100! 1 s,9io]
AREA WATTS
······-······ ··---·-··---·--------~-----'
TOTAI.AU.OWEDWATTS [ 7 c,rom LTG-4 otfrom oomputar.run.) ___________ .J
~ . . .
..
NOV-16-1998 14·: 17 6194806246 94¼ P.06
03/16/1995 05:47 6194806246 HAYNAL&CO PAGE 07
LIGHTING MANDATORY !Vl[ A SUf<F ·: LTG-MM
r~c~~~-·~~~--~-------------~------__._1°~~ 11/16/98 ___ ]
; IX'
1 .J
I ··1x· l .. ..l
I
I ,J
: IX! ! ! l
·--· .
-~ TMlluifdlnl.ffltlllnt~IYlll!tm~-lft t 131(d)18ulldlng Liahtlna
automatic time 1wttc
mmntdand,...
h, wllh • zone for 1111'1 floor; ortbt t,ulklfni • -,.l'tlllfy
thlnl.000 .... fNt;tlilmptffonttw~,...i....,.,
lnt·LlghU111111M-off: TheMCllllallollulldlnlthukfflpleffi la f 131(Cl)ZOven1•for8ulld
pmfdtd,wlttt • ~
of overtlde Is not
mllf,acc1a1111•1W9nldtewtlcblfteightoflhe..,_. n..,..
to exCNdf,(Nttsqua,-fNt.
~--CtftMled: Allauto!MllcMftlrol ........... f 111(h) Automatic Control
certtfled, ell alttmatlt .equipment•-" be~ and IMllllld • dlnlctlCI 11J the
manufacturtr.
and Lum"""'-c.tlltled: Atrfl..,...ctttt...._ epeclllld far Fluantacent llllaet
tint project .,. certlfttd and llell'd fn tht DINdorr, All lnltlfftd ftxtllrN ..... lie
certffltd. I
One and Tluw LtlMp P'luarilaNnt l'iiduNI: Alt, OM and·tlWe jl . / ·1 5 132 Tandem Wt,tng for
lamp fh,1orwcent fl
by Standan:t9 8tN:Uon
..... IIIIMlemwnctdltwo .......... Wht,9 .......
; 1»; or.a""'" IMlp ftuorNNnt....,,. ... .,,.elflldwttti
alectronlc· hlp-tr,q 1MM11N111iataand•re.-em,thtll.....,wlltnt
NCIUIN,nenll.
•·Controll: hchroolilandwlnthliabiallclll9•...,_ j I~] l 111(•) lncllvldu.l ~A
wlthaHpa....i.twnii
c.lllng walls.
h or OCGlllllftCY ""'°' .,_far each ll'li wtthftoor.4o-
·I ·xi I. ,,
/. I []
I
I
f 131(b) Uniform Reductlo n for lndlvldual Roome: AA~ end lll'tll l"*'UIM 100
ltMlft UWllla per-.-.Joot~..._folldntl lie . tquara fNt and mort
contfolledwlt!'I bl-lem •wltctlfftl for uniform Nductlon of lighting within the
room.
f 1S1(c) DtyllghtArN Contro
250 sq_,. ffft and
50% of the,.,..
I: All fOOfflt-,. WllldNI and MJJ!tldlt tMt.,. .....,-than
thatallll,W for the....,. ... ef flrflptln .. .,.. .........
In .-ch dtlyllt.,.. t.0t1"°"9d ~ ,_....,_IWllcfl; orttie
llgffl'OIMll-••n•MCI---IMwftldoM.,. err.cttn UH of daJ
contfnuoualy •had.d
durln, d..,.,_nt tlmN
by altuldfng onU.ldltetnt'9t D....,_ ofthldlng
of the.,.. 1a 1nc1uciecl on plailL.
i ·x1 ; [ f 131(f} Control ofExwrtor
panel IMlde the bU
lM roof and• COITtt
Lltfda:. Entrlor. mountlld tlatUfW'...,td froitl the •lttGlrtcal
ltdtng .,_..._offecS.wlth ·e·dlnlctloMI phol, oell connt on
)
'; I I I ; ..
l
ponding _, In the-electrtul plllll.
Dlepa.y llgMklt ilhall "..,.,...., 11Witehecl on clrollllll that t 131(a) Dllptay Lighting.
ant 20 ampa or IN ..
Designer Enforcement ·-·--
~-
. '~-.--~ ---·-···----·--·~-.
!
~
·--
I
·--·
I I
.j .......... · .• , .... -----------" ·. ___ E~P/01.0 __ ByEnergySolf • .. ----·w UMNllmb«:_. -~•-_, ____ Joll_N_1tt1_1•_-: ___________ P,ge10ft ]
NOU-16-1998 14:17 6194806246 947. P.07
Hazardous Materials
SAN DIEGO REGIONAL -~---·-
' ··-·.; .: 31' i:
. --• Plllllll l:llllil. llllllCJ
CIIITY IF IAI 11111
Business Name Contact Person Telephone
0 Jgt)) 4 3 ,g -771/y
Mailing Address City State Zip Plan File#
!7. f)f.
Zip Plan File#
PART I: FiRE DEPARTMENT-HAZARDOUS MATER ALS MANAGEMENT DIVISION: OCCUPANCY CLASSIFICATION
Indicate by circling the item, whether your buain!IH will uae, proce11; or 1tore any of the following t,azardous materials. If eny of·the items are
circled, applicant must contact the Fire Protection Agency with juriadiction prior to plan 1ubmittel.
1 . Explosive or Blasting Agent, ' 4. Flammable Solidi
C%)cornpressed Gases 5. Organic Peroxidea
7. Pyrophoric1 10. Cryogenics 13. Corrosives
8. Unstable Reectives 11. Highly Toxic or Toxic Materials 14. Other Health Hazards
3. Flammable or Combustible Uquids a. Oxidizera 9. Weter Reactive• 12. Redioactives
PART II: COUNTY OF SAN DIEGO HEALTH DEPARTMENT-HAZARDOUS MATERIALS MANAGEMENT DIVISION:
CONTINGENCY PLAN REVIEW; . .
If the answer to any of the questions i1 yes, applicant must contact the County of Sen Diego Hazardous Materials Management
Division, 1255 Imperial Avenue, 3rd Floor, Sen Diego, CA 92186-5261 •. Telephone (6191338-2222 prior to the issuance of a
building permit.
FEES MAY BE REQUIRED
Yes ,. !K] 2.c:J 3.0
4.0 s.o
No . D -Is your business listed on the reverse side of this form7 · rJI:! Will your business dispose of Hazardous Substances or Medical Waste in eny emount7
~ Will your business store or handle Hazardous Substencea in quantities ·equal to or greeter then 55 gallons,
500 pounds, 200 cubic feet or carcinogens/reproductive toxin_s in eny quentity7
Will your business use an existing or install en underground storage tenk7
Will your business store or handle AcLitely Hazardous Meterials7
PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT
OFFICE USE ONLY
0 RMPP Exempt
Date Initials Cl RMPP Required
Date Initials O RMPP Completed
Date
If the answer'to any of the q\lHtions is yH, applicant must contact the Air Pollution Control District, 9150 Chesapeake Drive, San Diego, CA 9
Telephone (6191 694-3307 prior to the i11uence of a building permit.
YES NO ·
1. O s:J Will the intended occupant install or use any of the equipment listed on the Listing of Air Pollution Control District Permit Categories, q tli
reverse side of this form7 · '
2. CJ [JS] (ANSWER ONLY IF QUESTION 1 IS YES.) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K tli gh
· 121 es listed in the current Directory of School end Community Coll•ge Districts, published by the Sal'! Diego County Office of Education a
the current California Private School Directory, compiled in accordance with provisions of Education Code Section 331907
Briefly describe nature ot the ,~tended 6u11ne11-ectiV1ty:
Name of Owner or Authorized Agent:
LY mJ ;5i.uAMq t ,,J
Signature of Owner or A horized Agent: I declare under penalty of perjury that to the best of my knowledge end belief the reeponses made herein ere true
and correct.-=--~"'~~~~~~~~~!:::::~ ...... --------~~--------Date: /} / / {p J 'Jl)J •
FIRE DEP_ARTMENT OCCUPANCY CLASSIFICATION: _____ -,-. _____________________________ _
BY: ______ ...., ____________ ,... ___________ .._ __ .,... ___ Date:. ________________ _
EXEMPT FIIOM PEIWIT IIEOUIIIEMDITS
COUNTY-HMMD
Eoviroammtal Hwtb.Senicca
DHS:HM-9171 (6/92)
APCD
APPIIOVID FOIi BUILDING PEIIMIT BUT NOT OCCUPANCY APPROVED FOIi OCCUPANCY
COUNTY-HMMD' APCO COUNTY-HMMD APCD
'2
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
Applicant:
DAVID GOULD
City of Carlsbad
Plan Check Revision Permit No:PCR99030
Building Inspection Request Line (760) 438-3101
2221 LAS PALMAS DR CBAD St: D
PCR
2130503100
$0.00
Lot#: O
Construction Type: NEW
RECONFIGURE OFFICE NEW DESIGN
-Stait·is: ('\1)P-ENCl.ll\lG/\i ,,.. ..t'J_';J-..J l .::..-·} "i"'-.1~ W!.i.!. V.i
Applied: 01721/1~-~RMT
Entered By: DT
Plan Approved:
Issued:
Inspect Area:
810 LOS VALLECITOS BLVD
SAN MARCOS CA 92069
760-471-0421
Total Fees: $55.00
FINAL APPROVAL
lnsp_ector: Date:
I I
1'
$55.00
Clearance: _____ _
NOTICE: Please take NOTICE thatapproval of your project includes the "Imposition" of fees, dedicaljons, reservations, or other exactions hereafter collectively
referred to as 'fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow:the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.Q30. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, voia, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which you have previously been oiven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161
02
55-00
'PEfl,IVll't APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas .Dr., Carlsbad CA 92009
(760) 438--1161
Sl/t,E$
FOR OFFICE USE ONL V
PLA~ CHE9K ~o.?cR~q o ~ o
EST. VAL. ___ -'.-____ _
Plan Ck. Deposit ..... · _______ _
Validated By -23 .
Date. \j 2-\/q CJ . . r t
Business: Name (at this address)
-tegal D&sciiptiOII, . Lot No. Subdivision Name/Numlier Unit No. Phase No. Total# of units
Existing Use , Proposed Use . , •
It1/Ji?(JI/EMEAJ1 · RECey..JF/6-i.Jll£. tJFAC.£;. g~l4CE Ta P/£Lu /.Jf-~16-Q o~/eG SA-cc.£ sa. FT. • Jof Stories · # of Bedr.ooms # of.Bathrooms
Name Alldreii . City .State/Zip Telephone #
:~~~· ~~~~-i'Jit
Name Address City· S~ate/Zip ·Telephone#
~ffli . ~ . "' ~~~
(Sec. 703:1 .5 Business and'Profassions Code: Any Cify 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 II signed statement that ha is licens.ad pursuant to the provisions of the Cont_ractors· License Law
(Chapter ·9, commending with Section-7000 of Divisi!Jn 3-of .iha Business and Professions Code) or that ha is axarript therefrom, and the basis for the allegl!'d
exemption. Any violation of Saction.7031.5 by any applicant for a permit subject~ the applicant to·a·clv,il P!nalty of not IT'ore than five hundred dollars ($500)).
•Name· Address City· State/Zip Telep_hone #
'State Licen·se # .a.·---------------license Class ________ __ City Bllsiness License # _______ _
Designer Name Addrasi ,/ City State/Zip Telephone
· State License #
ffi?E~fflttl~~--: -~ .. : . , _ , ~~~~
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one (!f the following declarations:
0 I have and will maintain II certificate of cons~nt'to self~insure for workers' compensation.as provided by ~action 3700 of the Labor Code, for the performance
of the work for which this permit is· issued.
0 I have and will maintain workers' compensation, as requirad by Stictj9n. 3100 of the Lab.or Code, for the performance of the work for which this permit is
issued. My·worker's compensation insurance carrier and policy number are:
'Insurance Company . , Polfcy No.·-----,.-----------Expiration Date _______ _
(THIS SECTiON·NEED NOT'BE. COMPLETED IF lHE PERMIT IS FOR ONE HUNDRED DOLLARS, ($100) OR;LESSJ
D CERTIFICATE OF EXEMPTION: I certify that in the performance !'f the work for .which this permit is issued, I shall not employ any p_arson in any manner so as
to become subject to the Worker11' Coinpansation Laws of Callfomii, ' •
WARNING: Failure jo secure worlcers' ·compensation covarage la unlawfui, and shaft subject an employer to crlmlnal.penalttes anci civil fines up to ·one hundred
thousand dollara ($100,000), ln·llddltlon to the coat of compenutlon, dal!lariaa u provkl,cl for In Section 3706 of the Labor c;ode, lnteres~ and attomay's fees.
SIGNATURE DATE ·
~11Wfl~~u•1.•~1f, _. . .
I hereby affirm that I am exempt from the Contractor's License Law for·tha.following reason:
·. ' '
D I, as owner of th11 property or my employees with wages ail their sole compensation, will' do the work and the structure is not intended or ·offered for ·sale
(Sec, 7044, Bu~iness and Profa~sions Code: The ·contr!lctoi''s License l,ew does not apply to ·an owner of·property who builds or Improves thereon, and who does
such work himself or through his own employaas, providad th11t su.ch !mprovemants-ara not intaiidad or offered'for 111111. If, however, the building or improvement is·
sold within,one YHr•of completion, the owner-builder will have the b~rd!ID of proving that he did not build o~ improve fpr._the purpose of sale).
D I, 11s owner of the property, ilm exclusivaly cor,tracting with licensed contractors to construct the ,project (Sic. 7044, i,u~iness an~ Professions Code: :rhe
·contractor's License·Law ifoes not apply to an owner of p(oparty who builds or Improves thereon, and contracts for such projects with contractor(sl ·licensed
pursuant·.to the Contractor·~ License ~w).
D ' ... .
I am exempt under Section--------Business and''Profasslons Coda for thl11 r1111son:
I.personally plan to provide the major labor and materials for con,truction of thll propose~ property Improvement. D YES ' ONO
· 2. I (have /-have,not) signe·d an application for a building·parmit for the proposad·work.
3. ·I have contracted _with the follpwl,:1g persor, (firm) to provide the proposed construction (Include name / address / ph_one nun:iber / contra<:tor~ l/ca!1se num~er):
4. I plan to provide portions of the Work, but I h11~11 hired the following person to.coordinate, supervise and provide the major work (include name·/ address/ phone
number/ contractors license numberl::-,.---------,.--------------------,---------------------
5. I will provide soma of the work,. bu1:' I h11v11 contracted (hiradi·the following parsons to-provide the·w~rk indicated (include 'name / address / phone number/ type
, ·of work): ·
PRPPl;RTY OWNER.SIGNATURE DATE ______ ~--
. ~~~1~~~Ji' ' "-' ·-,~,-~.
Is tha applicant or future building occupant required to submit II business ·j)(aii, acutily hazardous materials registration form or risk management and .prevention
program under Sections 25505, 255~3 or 25534 of the Presley~Tanner Hazardous Substance.Account Act-?-0-YES CJ NO. '
Is th11 applicant or future building oc_cupant req~ira~ to obtain_ a permit from-the air pollution control district or air quality management district? O YES D NO
·Is th11 f~cility-to be constructed witl:iin 1,000 f111~ of the outer boundary. of a school sit11? D YES 0. NO
IF_ANY ~F THE ANSWER~ ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS 1HE APPLICANT ~AS MET OR•IS MEETING THE
REQUIREMENTS,OFTHE OFFICI! OF.EMERGENCY SERVICES AND THE AIR POLLUTION"CONTROL DISTRICT. · . · · .
I hereby affirm that thece is a, con1'~ruction lendi~g ,ag~ncy fonhe p11rf!Jrm_1nc11 of th11 work for w_hich t~is permit is issued (Sac., ~097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS , ·
I~. -. . : " . . . -. jW~I~4.i~
I certify that·( have raad.tba application and state tha.t the above information.iii correct and that the Information on the plans is.accurate. 1 agree to comply with all '
City ordinanc~s end State lay.,s.relating· to building ponstruction. I, hera~y authorize representatives of th11 Citt of Carlsbad to enter upon the above mentioned ,
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND 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 0PERMIT.
OSHA: An OSHA permit is required f~r ax~ava~ions over 5'0~ d111p and demolition or construction of structures over .3 stories in height.
EXPIRATIO~: Every permit ls~uad :bY the Building ~i~ial under the provisions of this Code shall expire t,y 'limitation and become null and void if the building or
work authonzed.by s~ch par no omma . thm days e at11 of such permit or If.the building or work authorized by such permit is suspender!
or abandoned at 11nyt1m11 a erthe·w is omme d fo O ys.(Section 106.4.4Uniform Building Code). / ;· .
APPLICANT'S SIGNATURE l . DATE (/;;)._fr <j 9
WHITE: File YELL/W: Apphcant PINK: ·Finance \
. ,
DATE: 1/21/99
JURISDICtlON: Carlsbad
EsGil c·orporation
'1.n Partne.rs/i.ip wit/i. (joverrimett.t for q]uiUing Safety
PLAN CHECK NO.: PCR99-30(Orig.98-399.8) SET:I
PROJECT ADDRESS: 2221 Las Palmas Dr. ste C&D
D APPLICANT ~ D PLAN REVIEWER
D FILE
PROJECT NAME: Plan Check Revision-Occupancy Se.paration Wall
D 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 building codes
when minor deficiencies idef'.ltified in Remarks below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified oh the enclosed check lis~
and should be corrected and resubmitted for a complete recheck. C ..
O·. The check list transmitted herewith is for your information. The plans are being held at Esgil
·corporation until corrected plans are submitted for recheck. ·
D The applicaht"s copy of the check list is enclo$ed for the jurisdiction to forward to the applicant
contact person.
,.D The applicant's copy of the check -list has been sent to:
D Esgil Corporation staff did not advise the applicant that the plan check has been completed.
II Esgil Corp~ration staff did advise· the applicant that.the plan check has been cbmpleted.
Person contacted: David Gould
Date contacted:. (by:
In person plan review
Fax#:
Mail Telephone Fax . In Perso
· • Rl;MARKS: Please make (3S as in ~3.1 of the Owner Set Ill (cb98-3998)
approved :plans and .at the perforated 81/2 x 11 detail for the 1 hr. Occupancy
Separation wall to sh et 3.1to the City Set Ill (cb98-3998). David Gould will carry the
Owner Set Ill and extra sheet to ·the CitY of Carlsbad Building Department today. He was
advised that a permit may or may not'be issuecf at the time of delivery.
By: Mike Puckett Enclo$ures:
· Esgil Corporation
0 GA D. MB D 'EJ D PC log tmsmtl.dot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (619) 560-1468 + Fax (619) 560-1576
:· ,' •,
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:·· ... .-~ .. •
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•"
Oat~:
Time Sent
To:
· Phone#:
Fax#:
Remarks:
P.01
EsGil Corporation
1ti !Pa~netsfi.ip 'Ullt:fi <jovtrnmen.t for '1Juifalng Saft!tJ
FAX TftANS-MITTAL
Number of Pages Being Transmitted:
(Including Fax Transmittal}
From:
Hard Copy Mailed? YES 0
3
NO LJK
----~~--------~~"--------· ---~----~---~--~--------------------
9320 qt~apcake Drive, Suite208 + San Diego, California 92123 • (619) 560-1468 + Fax (619) 560-1576
P.02 . ·,,.; ... /<t~~:: ... "~''" .. :· '':(;'"'~'" .:~~~! ~--
• ' •,:• • .. .r-
. ~ .. .
<(~}~:-. :t.n Parttt,trs/i,ip witli. (jofletnment for 'BuiUing Safetg
): ~t1··0A-rE: 1/'21/99 D APPLICANT
Q JURIS.
:::.:,..Jf ~;U~lSDICTION; Carlsbad D PLAN REVIEWER
CJ FILE .:.:-: t~~i<' .'·: "
·: ... i)~?'!:.PLAN CHECK NO.: PCR99-30(Orig.98-3998) SET:I .... :: :ft,~-. ~ . . -
~.)f_.PROJECT ADDRESS: 2221 Las Palmas· Dr. ste C&D
·: . .' [(··PROJECT NAME: Plan Check Revisfoo .. Occupancy Separation Wall .. ,,
,'·:'·'
· .. ·· ;_'_.:'; D The plans transmitted herewith have been corrected where n~cessary and substantially comply
with the jurisdiction's buildi_ng codes .
• ••• '~. . ' ... :
.. ',: : .. ':
·_-... : ... ,0
:,. .··:;.(. '
:,t ·:_·_. ·o ' . . -.: ., .
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' -~: . . ~ :,: .... D ·. ;{_, . . .. =·-:··. -
. ' . ' ~ ···.-: D . , .
,• , .. ·: '
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·;-.•
. . ~ .
}i
The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified in Remarks below are resolved and checked by building
department staff.
The plans transmitted herewith have sign'ificant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
The check list transmitted herewith 1s for your information. The plans are being held at Esgil
Corporation 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 Corporation staff did not advise the applicant that the plan check has been completed .
E:sgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: David Gould In person plan review
Date contacted: (by: ) Fax #:
: J · . Mail Telephon~ Fax In Person
,·:::_:1t'<• · REMARKS: Please make notes as in red on sheet 3.1 of the Owner Set Ill {cb98-3998) .. : ib ·:. . approved plans and attach the perforated 81/2 x 11 detail for the 1 hr. Occupancy ·_. J? ·... Separation wall to sheet 3.1to the City Set Ill (c;b98-3998}. David Gould will carry the
·: ,#:-· Owner Set Ill and extra sheet to the City of Carlsbad Building Department today. He was
. : : ~(-: advised that a permit may: or may not be issued at the time of delivery.
,: ... :.~~~ ··.•. . .
. ·:. ·. By: Mike Puckett Enclosures:
.. · Esgil Corporation
· ·.,J;.. .... D GA O MB O EJ D PC log trnsmtl.dot
·. :-i:_... 9320 Chesapeake Drive. Suite 208 + San Diego, California 92123 + (619) 560-1468 + Fax (619) 560-1576
0 ":':·R' :.',"•,
: .. ·,
. f .. '
VALUATION AND PLAN CHECK FEE
JURIS0ICTION: Cartaha.d
PREPARED BY: Mike Puckett
PLAN CHE.CK NO.: PCR99w30(Orig.98-3998)
DATE: 1/21/99
BUILDING ADDRESS: 2221 Las Palmas Dr. ste C&D
·,:{.:-'-BUILDING OCCUPANCY: 8/S1/S3 TYPE OF CONSTRUCTION: VN
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BUILDING PORTION BUILDING AREA VALUATION VALUE
{ft.2) -MULTIPLIER ($)
Plan Check Revis.ion No Change See Comments See Comments
'
·--.
Air Conditioning
Fire Sprinklers
TOTAL VALUE See Comments
D 199 UBC Building Permit Fee D Bldg. Permit Fee by ordinance: $
0199 UBC Plan Check Fee D Plan Check Fee by ordinance: $
· Type of Review: D Complete Review D Structural Only • Hourly
D Repetitive Fe.e Applicable O Other:
Esgil Plan Review Fee: $ 43.58
Comments: Esgil Fee = ½ hr at $87.15/hr. =: $43.58
Sheet 1 of 1
macvalue.doc 5196
·:=. :··