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Home My WebLink About2653 Gateway Rd; 103; CBC2018-0694; PermitPERMIT REPORT Print Date: 03/16/2020 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Bathrooms: Project Title: 2653 Gateway Rd, 103 BLDG-Commercial 2131912500 $74,428.00 Commercial Permit Work Class: Tenant Improvement Lot#: Project#: Construction Type Orig. Plan Check#: Plan Check #: Description: HOOKED ON POKE: 1,150 SF RETAIL/FITNESS TO RESTAURANT Applicant: DONG DAO ARCHITECT DONG DAO Owner: REGENCY BRESSI LLC 4433 Convoy St, F San Diego, CA 92111-1600 858-279-4046 100 Wilshire Blvd, 700 SANTA MONICA, CA 90401 FEE BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL SB1473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-COMMERCIAL Total Fees: $ 1,007.31 Total Payments To Date : $ 1,007.31 Ccityof Carlsbad Permit No: CBC2018-0694 Status: Closed -Finaled Applied: 12/18/2018 Issued: 03/11/2019 PermitFinal Close Out: 03/13/2020 Inspector: PBurn Final Inspection: 03/13/2020 Contractor: SANWOOD FINE CARPENTRY AND CONSTRUCTION INC-INACTIVE 4514 Federal Blvd, Suite D San Diego, CA 92102-2517 619-429-1505 Balance Due: AMOUNT $516.75 $361.72 $60.00 $45.00 $3.00 $20.84 $0.00 Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees /exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Building Division 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov Page 1 of 1 {·cicyof Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Check ~2Q\9, Ol.D94 Est. Value 1~1'-\2."b- PC Deposit '3l.D.\.72. Date 12 -l'p-(£) APN: _________ _ D Addition/New: ___________ New SF and Use, ___________ New SF and Use, ____ Deck SF, Patio Cover SF (not including flatwork) enant Improvement: _,/--J/'1-L,,,'q}....._. __ SF, _____ SF, Existing Use _,,U'rlt=.,_,,,==--""''-Proposed Use Existing Use Proposed Use ______ _ 0 Pool/Spa: _____ SF Additional Gas or Electrical Features? ____________ _ D Solar: ___ KW, __ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No D Plumbing/Mechanical/Electrical Only: _________________________ _ D Other: --------------------------------- PROPERTY OWNER Name: -/.l..,~~.C..rt..J.!.!.,!!_p1,.f../.:..L__,,__ _____ Name: ___________________ _ Address: Address: __________________ _ City: City: _________ .State: __ ~Zip: ____ _ Phone: Phone: ___________________ _ Email: Email: ____________________ _ (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he/she is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 1 of2 Email: Building@carlsbadca.gov Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: ~hearby affirm under penalty of perjury one of the Jo/lowing declarations: Iii 1 have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. □ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be come subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to $100,000.00, In addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. -~~ ) CONTRACTOR SIGNATURE~--.,,...:;::........,64(11;~~,;;~""""------------□AGENT DATE: _____ _ ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the Jo/lowing reason: □ I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). □ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's license Law). 0 I am exempt under Section ________ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 Yes □ No 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone/ contractors' license number): s. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work): OWNER SIGNATURE: □AGENT DATE: _____ _ ---------------------- CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name: ______________________ Lender's Address: _____________________ _ ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 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? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes □ No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. APPLICANT CERTIFICATION: 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. 1 agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF 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 over3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void ifthe building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT SIGNATURE: ____________________ DATE: _______ _ 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of2 Email: Building@carlsbadca.gov Rev. 06/18 PERMIT INSPECTION HISTORY REPORT (CBC2018-0694) Permit Type: BLDG-Commercial Application Date: 12/18/2018 Owner: REGENCY BRESSI LLC Work Class: Tenant Improvement Issue Date: 03/11/2019 Subdivision: Status: Closed -Finaled Expiration Date: 03/13/2020 Address: 2653 GATEWAY RD, # 103 IVR Number: 16098 CARLSBAD, CA 92009-1758 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status 03/10/2020 03/10/2020 BLDG-Final Inspection 121871-2020 Failed Michael Collins Reinspection Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency See card for pick up. No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No 03/11/2020 03/11/2020 BLDG-Final Inspection 121963-2020 Cancelled Michael Collins Relnspection Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency See card for pick up. No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No 03/12/2020 03/12/2020 BLDG-Final Inspection 122073-2020 Partial Pass Michael Collins Reinspection Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency 3/12/20, minor pickup, ok to stock & train. Yes BLDG-Building Deficiency See card for pick up. No BLDG-Plumbing Final No BLDG-Electrical Final No 03/13/2020 03/13/2020 BLDG-Final Inspection 122221-2020 Passed Michael Collins Complete Checklist Item COMMENTS Passed BLDG-Building Deficiency See card for pick up. No BLDG-Building Deficiency 3/12/20, minor pickup, ok to stock & train. Yes BLDG-Building Deficiency Yes BLDG-Plumbing Final Yes BLDG-Plumbing Final No BLDG-Electrical Final Yes BLDG-Electrical Final No Friday, March 13, 2020 Page 2 of 2 CITY OF CARLSBAD PERMIT INSPECTION HISTORY REPORT (CBC2018-0694) Permit Type: BLDG-Commercial Application Date: 12/18/2018 Owner: REGENCY BRESSI LLC Work Class: Tenant Improvement Issue Date: 03/11/2019 Subdivision: Status: Closed -Finaled Expiration Date: 03/13/2020 Address: 2653 GATEWAY RD, # 103 IVR Number: 16098 CARLSBAD, CA 92009-1758 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status 05/07/2019 05/07/2019 BLDG-81 Underground 091105-2019 Passed Andy Krogh Complete Combo(11, 12,21,31) Checklist Item COMMENTS Passed BLDG-21 Yes U nderg rou nd-U nd erfloor Plumbing 05/30/2019 05/30/2019 BLDG-84 Rough 093171-2019 Partial Pass Andy Krogh Reinspection Incomplete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency As noted on card, no drops or hardlids No BLDG-14 No Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout No BLDG-34 Rough Electrical No BLDG-44 No Rough-Ducts-Dampers 07/18/2019 07/18/2019 BLDG-84 Rough 097948-2019 Passed Paul Burnette Complete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency As noted on card, no drops or hardlids Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 Yes Rough-Ducts-Dampers 07/23/2019 07/23/2019 BLOG-17 Interior 098361-2019 Passed Paul Burnette Complete Lath/Drywall Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes 02/25/2020 02/25/2020 BLDG-Final Inspection 120261-2020 Failed Paul Burnette Reinspection Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No Friday, March 13, 2020 Page 1 of 2 , - DATE: 12/31/2018 JURISDICTION: Carlsbad PLAN CHECK#.: CBC2018-0694 ✓• EsG1I A SAFEbuilfCompany SET: I PROJECT ADDRESS: 2653 Gateway Rd, # 103 PROJECT NAME: Hooked-On Poke Tenant Improvement □ APPLICANT ~RIS D The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. IZJ 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. D The check list transmitted herewith is for your information. The plans are being held at EsGil 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. D The applicant's copy of the check list has been sent to: IZJ EsGil staff did not advise the applicant that the plan check has been completed. D EsGil staff did advise the applicant that the plan check has been completed. Person contacted:~Q. Telephone#: Date contacted: ----itJtO ) Email: Mail Telephone Fax In Person IZJ REMARKS: Applicant to transfer the red clouded clarifiction on sheet M1 t set I plan prior to permit issuance. By: Jason Pasiut EsGil 12/20/2018 Enclosures: 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 ,. Carlsbad CBC2018-0694 12/31/2018 [DO NOT PAY -THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK#.: CBC2018-0694 PREPARED BY: Jason Pasiut DATE: 12/31/2018 BUILDING ADDRESS: 2653 Gateway Rd, #103 BUILDING OCCUPANCY: B BUILDING PORTION Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code cb 1997 UBC Building Permit Fee 1997 USC Plan Check Fee Type of Review: 0 Repetitive Fee .., Repeats Comments: AREA Valuation (Sq.Ft.) Multiplier 1150 64.72 By Ordinance • • Complete Review 0 Other D Hourly l!sGII Fee Reg. VALUE Mod. 0 Structural Only ,___ __ __,, Hr. @ * ($) 74,428 74,428 $312.231 Sheet 1 of 1 ELISE ROTHSCHILD Director Qtountp of $)an 110tego DEPARTMENT OF ENVIRONMENTAL HEALTH FOOD AND HOUSING DIVISION P.O. BOX 129261, SAN DIEGO, CA 92112-9261 Phone: (858) 505-6659 FAX: (858) 505-6824 1 (800) 253-9933 www.sdcdeh,QIT! AMY HARBERT Assistant Director PLAN APPROVAL SHEET DBA: HOOKED ON POKE DATE: 1/3//2019 SITE: 2653 GATEWAY RD #103 CARLSBAD BUSINESS OWNER: SAA Plans are approved contingent upon the following: PC#: DEH2018-FFPP-101530 1) Department of Environmental Health (DEH} stamped plans shall be maintained at the jobsite and available for review at the time of the inspection. 2) Changes to equipment layout, menu, or application must be submitted for approval. Changes made without approval will make the plan approval null and void. 3) Obtain local Building J?epartment and all applicable agencies permits and approvals PRIOR TO FINAL INSPECTION AND APPROVAL TO OPERATE BY THIS DEPARTMENT. 4) All food and utensil-related equipment shall be certified to applicable sanitation standards by an ANSI accredited testing agency. 5) Upon completion of 50%-80% of construction, email: celeste.penn@sdcounty.ca.gov. to schedule an inspection. In lieu of a plumbing inspection by DER, ensure that the plumbing is constructed to these standards: a. Floor sinks shall be installed ½ exposed and equipped with an appropriate grill cover if no access is provided for cleaning. b. Drain lines shall slope ¼" per foot, shall not exceed 15' in length and shall terminate a minimum of l" above the floor sink with a legal air gap or otherwise approved by the enforcing agency. Drain lines shall not intersect walkways or door ways. c. No condensate drainage of any kind can drain to the mop sink. d. 3-compartment sinks, preparation sinks, dump sinks, and any other plumbed equipment must drain indirect to a floor sink. e. Grease traps/interceptors, if required by the local waste water authority must be located outside of the food preparation, food storage, or warewashing areas. f. Floor surfaces must be sloped 1 :50 to required floor drains. g. Conduits of all types shall be installed within walls as practicable. When otherwise installed, they shall be mounted or enclosed in a chase so as to facilitate cleaning. 6) Owners and/or operators must pass an approved and accredited Food Safety Certification course. Proof of successful completion of this course is to be furnished at the final inspection. 7) All equipment is to be in place and functional. At the time when the final inspection is requested, the facility shall have all utilities operational and all refrigeration shall have an ambient air temperature of 38~F or below and shall be equipped with a thermometer accurate to+/-2°F in the warmest section of the unit. 8) Seal all cracks, gaps and crevices in counters, cabinets, around metal flashing, sink backsplashes, around pipes and conduits with silicone sealant. 9) AN AIR BALANC.E; REPORT IS REQUIRED IF THE FACILITY HAS VENTILATION HOODS. 10) ANY FOOD PROCESSING AREAS MUST BE COMPLETELY ENCLOSED. OPERABLE WINDOWS. MOVEABLE WALL PANELS. GA.RAGE ROLL-UP DOORS. OR OTHER MEANS OF RENDERING FOOD PROCESSING AREAS NOT FULLY ENCLOSED ARE NOT APPROVED. 11) Be a.dvised, applicable jurisdiction requirements that result in changes to approved plans may require revisions to the Department of Environmental Health plans. Plans reviewed by: Celeste Penn, REHS EMAIL: celeste.penn@sdcounty.ca.gov. AT LEAST 10 WORKING DAYS IN ADVANCE TO SCHEDULE INSPECTIONS. A FINAL INSPECTION MUST BE CONDUCTED AND AN ENVIRONMENT AL HEAL TH PERMIT SHALL BE ISSUED PRIOR TO OPENING AND OPERATING THIS FODD ESTABLISHMENT. "Environmental and public health through leadership, partnership and science" STORM WATER POLLUTION PREVENTION NOTES t. ALL NECESSARY EQUIPMENT AND MAlERIALS SliAU. BE AVAIi.ABLE ON SllE TO FACIUTAlE RAPID INSTALLATION OF EROSION AND SEDIMENT CONlRDI. BMPs \\liEN RAIN JS EMINENT. 2. THE DYINER/CONlRACTDR. SHAU. RESTORE ALL EROSION CONlRDL DE'IJCES TO WORKING ORDER TO THE SATISFACTION Of THE CITY INSPECTOR AfTER EACH RUN-Off PRODUCING RAINFALL 3. THE OWNER/CDNlRACTOR SHAU. INSTALL ADDITIONAL EROSION CONlRDL MEASURES AS MAY BE REQUIRED BY THE CITY INSPECTOR DUE TO INCOMPLElE GRADING OPERATIONS OR UNFORESEEN CIRCUMSTANCES \\lilCH MAY ARISE. 4. ALL REMOVABLE PROlECTIVE DE'IJCES SliAU. BE IN PLACE AT THE END Of EACH WORKING DAY \\liEN THE FIVE (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PECENT ( 40:I), SILT AND OllJER DEBRIS SHALL BE REMOVED AfTER EACH RAINFALL 5. ALL GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM AGGREGATE. 6. ADEQUAlE EROSION AND SEDIMENT CONlROL AND PERIMElER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. 7. lllE CITY INSPECTOR SliAU. HAVE lllE AUlHORJTY TO ALTER THIS PLAN DURING OR BEFORE CDNSlRUCTION AS NEEDED TO ENSURE COMPLIANCE W11H CITY STORM WATER QUALITY REGULATIONS. OWNl!R'S CER11FICATE: I UNDERSTAND AND ACJ<ND\\I.EDCE THAT I MUSn (t) IW'lSIOO BEST MANAGEMENT PRACTICES (IIUPs) DUIIING CONSlRUCllON ACTII/JTIES TO THE MAXIMUM EX1ENT PRAClJCAJJL.E TO AVOID THE MOBIUZATION OF POWJTANTS SUCH AS SEllJllEllT AND TO AVOID lH£ EXPOSURE OF ST0RLI WA1ER TO CONSTRUClK>N RELATED POUUTANlS: AND (2) ADHERE TO, AND AT AIL TIMES, COMPLY 1111H THIS CITY APPROVED lJER t OOIISlRUClJON st\l'PP THROUGHOUT THE DURA llON OF THE CONS1RUCTION AClll/JTIES UNlJL THE CONS1RUC1JON WORI( IS CDIIPLEIE AND APPROVED BY THE CITY OF CARLSBAD. OWNER{sVovmER s AG£NT NAME (PRINT) oWNER(s)loWNER'S AGENT NAME {SIGNAlURE) E-29 DAiE STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 ' CB ___ _ SW BEST MANAGEMENT·PRACTICES (BMP) SELECTION TABLE Besl ManagemenJ PracUce' (BMP) OesCl!pllon ➔ CASCA Desfglllllon ➔ Conslruc:IIDnkthily Gradin D sturban~ Tr In cavotlon s UJn lltllln, Concrate§halt Scawcuttlng Concrete Aalworic PG'Mg Conduit~• insta1lal\an Stucco/ ortar ~ 11 w.s,.l ... 1 =~== GncfFu~ft Hazo[dous SUbslance lJse(Sbmml. DewateriRg Sita Access Across Dirt I Other (11st): -""""' ..... i 'l!I ... ~ ·1 • '6 i~ ! ... i ,. ol ,; -g ael .t Ill iG ,ll~ ,_ m D ~ M°M M ...... _,, ..... ~ Ii £ i I l J :i m .!!D 8 5 ~ ,g i .. 1 f l ~ ·a Ii! .,i I. ,li:I' ~ i ~ "I ill bl ~ .. m ill ill -1--CofllrolBMPs ManagemenlBMPs • j ~ J 'll m • i ! i j !j I ... le 1& iii a:a ]! :!!~ "'" .. ,; .P :;;~ ~= 1¥ I ., !i ~~ ;$.e' i! ,: ce la 5! ~ N j; l i m ill i!s J, z z z Waste ~and Malerials PoWonConlrDIBMPs -a 5 ,:I 5 !i _5 u ~ g'c -;; .S .E I 8 ,!! -i-=-s :i 2 Ii .S5 ,..5 ~& l u. ~ i !-w ii js ! j ! ii i I ;J i! :i al ~ lilil 1111 I I l Instructions: 1, Check the box to the left of all appllcable conatrucUon octl~ty (first column) expected to occur during constnictlon. 2. Located olon_g the top of the BMP Table Is a list of BMP's with ll's c:orresP.Ondln9 Collfomlo Stonnwalet Quality AssoctoUon (~ deslgnotton number, Choose one or more BI.IPS )OU Intend to use during construction l'rom the JfsL Check Uta box where the chosen activity raw lnletaacts with the BJdP column, 3. Refer to the CASQA construction handbook-for lnfonnotioJI aruf ~atob ~~ the chosen BMPs and how to apply them to the projecL SHOW THE LOCATIONS OF ALL CHOSEN BMPs ABOVE ON THE PROJECTS SITE P~OSJON CONTROL PLAN. SEE THE REVERSE SIDE OF THIS SHEET FOR A SAMPLE EROSION CONTROL PLAN. -BMP's are subject to field inspection- Page 1 of 1 PROJECTINFORMATI~N St1o ...._ I U "?'.Mr~wtcl 4.d- .,....,.,, Pared Numbor. 2£)S,-l2c-%7 ".e.o Emergency Contacl:&j Name: '§'!\ti\: e;,~ 24HourPhon£ j~O ";,:23, 'f)~O Construction Threat to Stonn Water Ouollty (Chock Box) □ MEDIUM )lit LOW REV D2{16 I i I !