HomeMy WebLinkAbout2701 Loker Ave W; 150; CBC2019-0312; Permit(city of
Carlsbad
Print Date: 09/17/2019
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
2701 Loker Ave W, 150
BLDG-Commercial
2090812200
$33,787.60
Commercial Permit
Work Class: Demo
Lot#:
Reference#:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check #:
Description: PALOMAR CREST: 5,485 SF INTERIOR DEMO (NO OCCUPANCY ON THIS PERMIT)
Owner:
Status:
Applied:
Issued:
Permit
Fina led:
Inspector:
Final
Inspection:
Contractor:
Permit No: CBC2019-0312
Closed -Finaled
06/24/2019
06/28/2019
9/17/2019 2:34:02PM
REEF PALOMAR LLC SP W CONSTRUCTION INC
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
S91473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOT\ON-COMMERCIAL
Total Fees: $527.58
2701 Loker Ave
CARLSBAD, CA 92008
Total Payments To Date: $527.5B
2524 Gateway Rd
Carlsbad, CA 92009-1742
760-931-1130
Balance Due:
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these
fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the
protest 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.
$0.00
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
$303.60
$212.52
$2.00
$9.46
._
(cicyof
Carlsbad
COMMERCIAL
BUILDING PERMIT
APPLICATION
B-2
Plan Check ,8(2.-0/f-05/2._
Est. Value '33,J~ 7.QI
PC Deposit --=--------
Date ~~""'/Z.._L/~/-'--'/f __ _
Job Address :2701 Lolzer Ave""ue west Suite: _1_5_o __ APN: Zof og(;-4:.A--OO
Tenant Name: _"'-_1_ci ______________ CT/Project #: __________ Lot#: ___ _
Fire Sprinkler~ no Air Conditioning:~/ no
BRIEF DESCRIPTION OF WORK: oleV\,\,oLitio"'-of existl"'-g wciLLs Cl"'-ol fl"'-ist-1es, V\,\,i"'-Or griol repciirs, pcitct-1 CIV\,ol
CICV\,t ciffecteol WC!lls ~ i:-
D Addition/New: ___________ New SF and Use, ___________ New SF and Use,
___ Deck SF, Patio Cover SF (not including flatwork)
D Tenant Improvement: _____ SF,
_____ SF,
Existing Use ______ 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: ________________________ _
Ill! Other: "'-O te""ci""t for tt-1e s cice -clrn""u Cl"'-ol oleV\,\,o o suite O"'-L
APPLICANT (PRIMARY)
Name: SPW COV\,StructioV\,
Address: :25:24 ';iC1tewci1:;1 RoC!ol
City: CC!rlsbciol State: CA Zip: '.):200'.)
Phone: 700.'.)31.1130
Email: "'-Cl"'-CkJ@wviiteco"'structio""i"'c.coV\,\,
DESIGN PROFESSIONAL
Name: AVRP Siz!jport
Address: J03 10tvi street suite :200
City: SCIV\, Diego State: CA Zip: j:2101
Phone: 019-704.:2700
Email: _______________ _
Architect State License: __________ _
PROPERTY OWNER
Name: Reef PciLoV\,\,Clr, LLC clo l.-t"'-ire ReC!L 5stcite
Address: 1200 5Clst IV\,\.ptriCIL rtieviwC!cJ Suite :205
City: lsrrn State: CA Zip: '):22:21
Phone: J-11:,;l_;)0.21 QQ
Email: I cickcrtci rr1:;1 l¾CI "'®L--t"'-irec;rou:p.col¾
CONTRACTOR BUSINESS
Name: SPW COV\,StructioV\,
Address: :25:24 c;citeWC!cJ Rocio!
City: c0rksb00 State: CA Zip: _.'2cc:2c:.o..::.o ... 9 __ _
Phone: 700.'331.1130
Ema 11: "'-Cl "'-Ci;;! ®wVl iteco "'s tructio "''"'c. COV\,\,
State License: 10:23250 Bus. License: lsLNR000431-0:2-:2C
(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, commendlng with Section 7000 of Division 3 of the Business and Professions Cadet or that he/she is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}).
1635 Faraday Ave Carlsbad, CA 92008
B-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 1 of 2
Email: Building@carlsbadca.gov
Rev. 06/18
I OPTION A): WORKERS'COMPENSAJION DECLARATION:
I hearby affirm under penalty of perjury gg_ of the following declarations:
□ I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the
work which this permit Is issued.
~ have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carrier and policy number are: Insurance Company Name: State Compensation lns. Fund
Polley No. 9243036-19 E>eplration Date: 01/01/2020
□ Certificate of ElCemption: 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: ----1::::::::=,...,,.. ____________ uAGENr DATE:~1e'""'l""'2;=-4.:.+-J/1~Ci=--bL---I I
( OPTION B ): OWNER-BUILDER DECLARATION:
J hereby affirm that/ am exempt from Contractor's License Law for the following reason:
0 l, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractor's License law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
□ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
□ I am exempt under Section _______ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No
2. I (have/ have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number):
4. I plan to provide portions of the work, but I have hired ttie following person to coordinate, supervise and provide the major work {include name/ address/ phone/
contractors' license number):
5. 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: __________________ LJAGENT DATE: _____ _
CONSTRUCTION LENDING AGENCY. IFANY:
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 ONLV;
ls 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 Pres!ey-Tanner Hazardous Substance Account Act? □ Yes ,,sJ 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 11 No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ 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. I 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 S'O' deep and demolition orcon~ruction of structuresover3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by !imitation and become null and 1/0id if the building or work authorized
by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit ls suspended or abandoned at any time
after the work ls commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). (/~
APPLICANT SIGNATURE: _ __;ff:.._ _________________ DATE: _0_1_:2_4_1_1.')"------
1635 Faraday Ave Carlsbad, CA 92008
B-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 2 of 2
Email: Building@carlsbadca.gov
Rev. 06/18
1 ''t ,, 'f 1~ } ,, '\) > ,, 4 a; \ 1 i ' ' ' 1,f ,, J (' • '" ," ' '. J
;/t:'.' , ~::,,~, · ~ ~\' • \,,, · . fJ:RMlt •lll~P~cT10~ H1stro1v ffllo,~1'. <eaclo,19.o,12t -. \• · -
P0rm1t rypc:
Work Class·
Statu~; ·
Scheduled
Date
BLDG-Commercial
Demo
Closed -Finaled
Actual
Start Date Inspection Type
Application Date: 06/24/2019
Issue Date: 06/28/2019
Expiration Date: 03/16/2020
IVR Number: 19946
Inspection No. Inspection Status
0911712019 0911712019 BLOG-11
FoundationlFtg/Pier
s (Rebar)
104399-2019 Passed
BLOG-Final
Inspection
Checklist Item
BLDG-Building Deficiency
104400-2019
Chee klist Item
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
COMMENTS
Passed
COMMENTS
Ownci-:
Subdivi1">ion:
Address:
Primary Inspector
Paul York
Paul York
REEF PALOMAR LLC
CARLSBAD TCT#74-21
2701 Loker Avew , 150
Carlsbad, CA 92010-6641
Re inspection
Passed
Yes
Passed
Yes
Yes
Yes
Yes
Yes
Complete
Complete
Complete
September 17, 2019 Page 1 of 1
ltl-8S8-6n-8900
fiee • IISl-ltl-4522
fax -858-677-900'1
PatJlotlAll.oom
June 17, 2019 66•0 LIiii Blvd., Switt A-100, San Dit110, CA 92111 Environmental Laboratory Services, Inc.
Darrin Ward
White Construction
2524 Gateway Road
Carlsbad, CA 92009
Re: Limited Asbestos Inspection
Palomar Crest Suite 150
2701 Loker Avenue Suite 150
Carlsbad, CA 92008
Claim No: NIA
Project No: SD 129383A
Dear Mr. Ward,
RECEi\/ED
JUtl 2 ,t 2019
CITY OF cr,:0n SB/\D
BLJILDlr.Jl~ u . :.:c:•J
On June 14, 2019, California DOSH Certified Site Surveillance Technician, Mr. Francisco
Barney (CSST 14-5283) of Patriot Environmental Laboratory Services, Inc. (Patriot) performed
a limited asbestos inspection at the above subject property located in Carlsbad, California. The
purpose of the inspection was to determine if asbestos is present in any of the building
materials soon to be disturbed by an upcoming renovation at the subject property.
Summary of Findings
No asbestos was detected in the building materials sampled.
Property Description
The subject property is a commercial structure. The subject building is a multi-story wood and
metal frame building set on a cement slab foundation.
Scope of Work
On June 14, 2019, Mr. Francisco Barney, (CSST 14-5283) of Patriot conducted a limited
asbestos inspection at the subject property. The interior of the building was visually inspected for
the purpose of inventorying any suspect asbestos containing materials soon to be disturbed by an
upcoming renovation at the subject property. Once the inventory of suspect materials was
created, physical bulk samples were collected of the materials from representative locations.
Samples were collected in airtight containers. Upon collection, sample numbers, descriptions,
and collection locations were entered on to a chain of custody for transportation to Patriot's
NVLAP accredited laboratory.
>-,_ -0
Sampled Suspect Materials
Samples of the following suspect materials were collected:
Drywall & Joint Compound Carpet Mastic Black 4" Cove Base
with Mastic
2'x4' Acoustic CT 12" Vinyl Floor Tile Pink Fiberglass Duct Insulation with White Mastic
Sample ProtocoVAnalysis ,_-
/
,/ , '' I --··--. I
Samples were collected in accordance with the Asl,~~,tos. ~chool H"""azard EmeTgency Re1"onse
Act (40 CFR 763 Subpart E) as mandated by Cal/QSHA ('fitle 8 Section 1529). . /
\ ·, I } ! ' ' -·,, d '/ 11 .i I ;
Physical bulk samples were analyze9. by Patriot. P11triot. is accredited bx ihj:--Watio-!:tal ~ oluntary
Laboratory Accreditation ProgranJ,{200358-0). The met,hod of analysi& was:Jfol~zecf Light
Microscopy (EPA 600/M4-82-0,20))) . · · : 1 // 1 .. , 1 • /.
'. ✓ / ) ·.__ ._) I, I / { .~\,\\) i .. I ,/
) I ~ I
Recommendations
' ' i .,,--.. ---.' i ----
No asbestos was detected in the buil\iing materials ~ampled. Therefore, no recommendations.:are
warranted at this time. \ ' ) · 1
/ .;~ --~ i
/ / \ ' , ~---__ ,,. ,,..,..-· ; /
' / I I
Disclaimer 1 \.., , .. \ 1 / r-· _ ..
,/ ·. \, ' \,.", \ ;' ' ' /
changes or changes izythe condition of tbe building. ' :' / /
/ \ \ ' J '} } .' ---._
Limited destructive sampJ'ng)waii\06,ducted at the subject property. If additional-suspect'/
materials are discovered d'(llajg rerioxation, all work should cease until a Certified Asbes}os /
Consultant is contracted to\1Scertain the possibiJJty of iisbestos content.,.'this inspection Was /
performed in accordance with current r'egula1/QilS(~fkr1rte of the arl;,~J~qes. Th~ invc;rttory of
asbestos contain~ng mat_e;i'als lifd detepmn~fiol,i o~_!bqr cotjdition ~.~ ~~e<,i upon,.con1tiorys
observed at the tune oY,nspect!Qn. Patilot does mltl ass:t ~espons1b1fity for futute regulatpry
Enclosed is the la~;atory analysi~\-eport, Pi~ase. contact ur office if ther~ arekiy ~~e~~;s
regarding this i~~ection. ./ / ',, // ,, .. ,) __ .. :,. . . ,_/
Sincerely, ,./ ,/ ,-/_,.,,/ 1 /-/.,, .. ~
/ / ;'/ \ I _,,, ~ ,/',) , __ ,,. ••••
/ \ ~-~ / // \ ".' ,:··,
T / 1,
I _. / 1 I . , : /
Cristophe~ J. Meile : / /.
Certified Aisbestos Consultrult 08-43}1() \
I I /
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Enclosure:):.aboratory Rfsults /
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Certificale of Analysis
PLM Asbestos Identification tel· 858·677-8900
free -855-787-4522
fax -858-6n-9009
Patriotlab.com
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
White Construction Report Number: 770542
Darrin Ward Project Number: SD129383A 2524 Gateway Road Project Name: Palomar Crest Suite 150 Carlsbad, CA 92009
Project Location: 2701 Loker Avenue Suite 150
Carlsbad, 92008
Date Collected: 6/14/2019 Collected By: Francisco Barney
Date Received: 6/14/2019 Claim Number:
Date Analyzed: 6/14/2019 PO Number:
Date Reported: 6/14/2019 Number of Samples: 46
Lab/Client ID/Layer Location Material Description Color
770542-001 Computer Area Wall Drywall and Joint White
Compound
Total Asbestos None Detected
770542-00IA Computer Area Wall DrywaU White
Total Asbestos None Detected
770542-00lB Computer Area Wall Joint Compound White
Total Asbestos None Detected
770542-002 Office 5 Wall Drywall and Joint White
2 Compound
Total Asbestos None Detected
770542-002A Office 5 Wall Drywall White
2
Total Asbestos None Detected
Composition ( % )
80% Sulfate
10% Cellulose
6% Carbonate
2 % Glass Fibers
2% Paint
85% Sulfate
10% CeUulose
5% Glass Fibers
97% Carbonate
3% Paint
80% Sulfate
10% Cellulose
6% Carbonate
2% Glass Fibers
2% Paint
85% Sulfate
I 0% Cellulose
5% Glass Fibers
Page I of9
G:ertificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-00ZB Office 5 Wall
2
Total Asbestos None Detected
770542-003 Office 20 Wall
3
Total Asbestos None Detected
770542-003A Office 20 Wall
3
Total Asbestos None Detected
770542-003B Office 20 Wall
3
Total Asbestos None Detected
770542-004 Lobby Wall
4
Total Asbestos None Detected
Report Number:
Project Number:
Project Name:
Project Location:
Collected By:
Claim Number:
PO Number:
Number of Samples:
tel· 858·677-8900
free -855-787-4522
fax -858-677-9009
Patriotlab.mm
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
770542
SDJ29383A
Palomar Crest Suite 150
270 I Loker A venue Suite 150
Carlsbad, 92008
Francisco Barney
46
Material Description Color Composition ( % )
Joint Compound White 97% Carbonate
3% Paint
Drywall and Joint White 80% Sulfate
Compound 10% Cellulose
6% Carbonate
2% Glass Fibers
2% Paint
Drywall White 85% Sulfate
I 0% Cellulose
5% Glass Fibers
Joint Compound White 97% Carbonate
3% Paint
Drywall and Joint White 80% Sulfate
Compound 10% Cellulose
6% Carbonate
2% Glass Fibers
2% Paint
Page2of9
Certificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14n0I9
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-004A Lobby Wall
4
Total Asbestos None Detected
770542-004B Lobby Wall
4
Total Asbestos None Detected
770542-005 Office I 5 Wall
5
Total Asbestos None Detected
770542-005A Office 15 Wall
5
Total Asbestos None Detected
770542-005B Office 15 Wall
5
Total Asbestos None Detected
tel· 858·677-8900
free -SSS-787-4522
la~· 858-671-9009
Patriotlab.wm
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
Report Number: 770542
Project Number: SD129383A
Project Name: Palomar Crest Suite 150
Project Location: 2701 Loker Avenue Suite 150
Carlsbad, 92008
Collected By: Francisco Barney
Claim Number:
PO Number:
Number of Samples: 46
Material Description Color Composition ( % )
Drywall White 85% Sulfate
10% Cellulose
5% Glass Fibers
Joint Compound White 97% Carbonate
3% Paint
Drywall and Joint White 80% Sulfate
Compound 10% Cellulose
6% Carbonate
2% Glass Fibers
2% Paint
Drywall White 85% Sulfate
10% Cellulose
5% Glass Fibers
Joint Compound White 97% Carbonate
3% Paint
Page 3 of9
Certificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-006 Office JO Wall
6
Total Asbestos None Detected
770542-006A Office JO Wall
6
Total Asbestos None Detected
770542-006B Office!O Wall
6
Total Asbestos None Detected
770542-007 Breakroom Wall
7
Total Asbestos None Detected
770542-007 A Breakroom Wall
7
Total Asbestos None Detected
tel • 858-677-8900
free -855-787-4522
fal -858-6n-9009
Patriotlab.com
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
Report Number: 770542
Project Number: SD129383A
Project N arne: Palomar Crest Suite 150
Project Location: 270 I Loker Avenue Suite 150
Carlsbad, 92008
Collected By: Francisco Barney
Claim Number:
PO Number:
Number of Samples: 46
Material Description Color Composition ( % )
Drywall and Joint White 80% Sulfate
Compound I 0% Cellulose
6% Carbonate
2% Glass Fibers
2% Paint
Drywall White 85% Sulfate
10% Cellulose
5 % Glass Fibers
Joint Compound White 97% Carbonate
3% Paint
Drywall and Joint White 80% Sulfate
Compound 10% Cellulose
6% Carbonate
2 % Glass Fibers
2% Paint
Drywall White 85% Sulfate
10% Cellulose
5% Glass Fibers
Page 4 of9
Clertificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-007B Breakroom Wall
7
Total Asbestos None Detected
770542-008 Lobby Floor
8
Total Asbestos None Detected
770542-009 Office 8 Floor
9
Total Asbestos None Detected
770542-010 Computer Area Floor
10
Total Asbestos None Detected
770542-011 Office 14
II
Total Asbestos None Detected
770542-012 Corridor Floor
12
Total Asbestos None Detected
Report Number:
Project Number:
Project Name:
Project Location:
Collected By:
Claim Number:
PO Number:
Number of Samples:
tel· 858·677·8900
free· SSS-787·4522
fax· 858·677-9009
Patriotlab.rom
6640 Lusk Blvd., Suite A·lO0, San Diego, CA 92121
770542
SD129383A
Palomar Crest Suite I 50
2701 Loker Avenue Suite 150
Carlsbad, 92008
Francisco Barney
46
Material Descrij!tion Color Composition ( % )
Joint Compound White 97% Carbonate
3% Paint
Carpet Mastic Yellow 100% Non-
Fibrous Material
Carpet Mastic Yellow 100% Non-
Fibrous Material
Carpet Mastic Yellow 100% Non•
Fibrous Material
Carpet Mastic Yellow 100% Non·
Fibrous Material
Carpet Mastic Yellow 100% Non-
Fibrous Material
Page 5 of9
Certificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-013 Computer Area Wall
13
Total Asbestos None Detected
770542-014 Computer Area Wall
14
Total Asbestos None Detected
770542-015 Office 12 Wall
15
Total Asbestos None Detected
770542-016 Office 12 Wall
16
Total Asbestos None Detected
770542-017 Office 22 Wall
17
Total Asbestos None Detected
770542-018 Office 22 Wall
18
Total Asbestos None Detected
Report Number:
Project Number:
Project Name:
Project Location:
Collected By:
Claim Number:
PO Number:
Number of Samples:
tel -858·677-8900
free -85>-787-4522
fax -858-677-9009
Patriotlab.com
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
770542
SDl29383A
Palomar Crest Suite 150
270 I Loker A venue Suite 150
Carlsbad, 92008
Francisco Barney
46
Material Description Color Composition ( % )
4 Inch Cove Base Black 100%Non-
Fibrous Material
Mastic Beige 100% Non-
Fibrous Material
4 Inch Cove Base Black 100% Non-
Fibrous Material
Mastic Beige 100% Non-
Fibrous Material
4 Inch Cove Base Black 100%Non-
Fibrous Material
Mastic Beige 100%Non-
Fibrous Material
Page 6 of9
G:ertificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer
770542-019
19
Total Asbestos
770542-020
20
Total Asbestos
770542-021
21
Total Asbestos
770542-022
22
Total Asbestos
Location
Computer Area Ceiling
None Detected
Lobby Ceiling
None Detected
Office 9 Ceiling
None Detected
Corridor Ceiling
None Detected
tel· 858·677·8900
free • 855-781-4522
fax -858-677-9009
Patriotlab.com
6640 Lusk Blvd., Suite A-100, San Diego, CA 92111
Report Number:
Project Number:
Project Name:
Project Location:
Collected By:
Claim Number:
PO Number:
770542
SDJ29383A
Palomar Crest Suite 150
2701 Loker Avenue Suite 150
Carlsbad, 92008
Francisco Barney
Number of Samples: 46
Material Description Color
2x4 Inch Acoustic CT White
2x4 Inch Acoustic CT White
2x4 Inch Acoustic CT White
2x4 Inch Acoustic CT White
Composition ( % )
65% Cellulose
20% Mineral
Wool
12% Perlite
3% Paint
65% Cellulose
20% Mineral
Wool
12% Perlite
3% Paint
65% Cellulose
20% Mineral
Wool
12% Perlite
3% Paint
65% Cellulose
20% Mineral
Wool
12% Perlite
3% Paint
Page 7 of9
Certificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-023 Office 10 Ceiling
23
Total Asbestos None Detected
770542-024 Office 14 Floor
24
Total Asbestos None Detected
770542-025 Office 14 Floor
25
Total Asbestos None Detected
770542-026 Corridor Floor
26
Total Asbestos None Detected
770542-027 Corridor Floor
27
Total Asbestos None Detected
770542-028 Office 13 Floor
28
Total Asbestos None Detected
tel· 858·677-8900
free -855-787-4522
fax -858-6n-9009
Patriotlab.rom
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
Report Number: 770542
Project Number: SD129383A
Project Name: Palomar Crest Suite 150
Project Location: 270 I Loker Avenue Suite 150
Carlsbad, 92008
Collected By: Francisco Barney
Oaim Number:
PO Number:
Number of Samples: 46
Material Description Color Composition ( % )
2x4 Inch Acoustic CT White 65% Cellulose
20% Mineral
Wool
12% Perlite
3% Paint
12 Inch Vinyl Floor White 100% Non-
Tile Fibrous Material
Mastic Yellow 100% Non-
Fibrous Material
12 Inch Vinyl Floor White 100% Non-
Tile Fibrous Material
Mastic Yellow 100% Non-
Fibrous Material
12 Inch Vinyl Floor White 100% Non-
Tile Fibrous Material
Page 8 of9
Certificate of Analysis
PLM Asbestos Identification
White Construction
Darrin Ward
2524 Gateway Road
Carlsbad, CA 92009
Date Collected: 6/14/2019
Date Received: 6/14/2019
Date Analyzed: 6/14/2019
Date Reported: 6/14/2019
Lab/Client ID/Layer Location
770542-029 Office 13 Floor
29
Total Asbestos None Detected
770542-030 Plenum Ducts
30
Total Asbestos None Detected
770542-031 Plenum Ducts
31
Total Asbestos None Detected
770542-032 Plenum Ducts
32
Total Asbestos None Detected
Krystal Prodigalidad -Analyst
Report Number:
Project Number:
Project Name:
Project Location:
Collected By:
Claim Number:
PO Number:
Number of Samples:
tel· 858·677·8900
free -855-787·4522
tax • 858•6n-900'J
Patriotlab.(Om
6640 Lusk Blvd., Suite A-100, San Diego, CA 92121
770542
SD129383A
Palomar Crest Suite 150
2701 Loker Avenue Suite 150
Carlsbad, 92008
Francisco Barney
46
Material Description Color Composition ( % )
Mastic Yellow 100% Non-
Fibrous Material
Fiberglass Duct Pink 100% Mineral
Insulation Wool
Fiberglass Duct Pink I 00% Mineral
Insulation Wool
Fiberglass Duct Pink I 00% Mineral
Insulation Wool
Michelle Lavallee -Approved By
Bulk sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR 763, Subpart F, Appendix
A; EPA-600/R-93/116 (M"ethod for Determination of Asbestos in Building Materials), and EPA-600/M4-82-020 (US EPA Interim Method for the
Determination of Asbestos in Bulk Insulation Samples).Samples were analyzed using Calibrated Visual Estimations (CVES); therefore, results may not be
reliable for samples of low asbestos concentration levels. Samples of wall systems containing discrete and separable layers are analyzed separc1.tely and
reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items
tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected. ''None
Detected" means that no asbestos was observed in the sample. "<. l %" (less than one percent) means that asbestos was observe.din the sample but the
concentration is below the quantifiable level of 1 %. This report was issued by a NIST/NVLAP (Lab Code 200982.Q) and CADOHS· ELAP (Cert. No.
2805) accredited laboratory and may not be reproduced, except in full without the expressed written consent of Patriot Environmental Laboratory Services,
Inc. This report may not be used to claim product certification, approval or endorsement by NIST, NVLAP, ELAP or any government agency.
Page 9 of9
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fall· 408-63a-G945 ~um Arounc(!JJ:lw:
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Pal!IGllab.com
2186 Paragon Drive, San J111t, CA 95131
ASBESTOS FIELD BULK SAMPLE COC
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Bulk Sample COG Rev 12.27.2017
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS
QUESTIONNAIRE
OFFICE USE ONLY
RECORD ID #--------~---------1
PLAN CHECK# cec.2~9 -0 3 1 :i-
sP DATE
The following questions rep sent the facility's activities, NOT the specific project description.
PART I: FIRE DEPARTMENT -HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San
Diego): Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled,
applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal.
Occupancy Rating: Facility's Square Footage (including proposed project):
1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives
2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These.
4. Flammable Solids 8. Unstable Reactives 12. Radioactives
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION (HMO): If the answer to any of the
questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 110, San Diego, CA 92123. can (858) 505-6700 prior to the issuance of a building permit.
FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: 0 CalARP Exempt
I
1.
2.
3.
4.
5.
6.
7.
8.
YES NO □ E:f □ 13' □ 13'
csr ~
(for new construction or remodeling projects)
Is your business listed on the reverse side of this form? (check all that apply).
Will your business dispose of Hazardous Substances or Medical Waste in any amount?
Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500
pounds and/or 200 cubic feet?
Will your business store or handle carcinogens/reproductive toxins in any quantity?
Will your business use an existing or install an underground storage tank? □ □ □ □ □
G}-Will your business store or handle Regulated-Substances (CalARP)?
[9" Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? rr' Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to
or reater than 1,320 allons? California's Above round Petroleum Stora e Aci .
Date Initials
0 CalARP Required
I
Date Initials
0 CalARP Complete
I
Date Initials
PART 111: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCDI: Any YES• answer requires a stamp from APCD 10124 Old Grove Road, San
Diego, CA 92131 apcdcomp@sdcounty.ca.qov (858) 586-2650). [•No stamp required WQ1 Yes.MQ Q3 Yes and Q4-Q6 No). The following questions are intended
to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified by these questions. For comprehensive
requirements contact APCD. Residences are typically exempt, except -those with more than one building+ on the property; single buildings with more than four
dwelling units; town homes; condos; mixed-commercial use; deliberate burns; residences forming part of a larger project. rExcludes garages & small outbuildings.}
YE~ N□O 1. B Will the projeci disturb 160 square feet or more of existing building materials?
2. Q, g
0
Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition.
3. t::::1 (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos suivey been performed by a Certified Asbestos Consultant or Site Surveillance
Technician?
4.
5.
6.
□
□
□
[3' (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification
may be required 10 working days prior to commencing asbestos removal. s' Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet
(www.sdapcd.org/info/faqts/permrts.pdf) for typical equipment requiring an APCD permit. D (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school
bounda
Briefly describe proposed project:
(\tm~ Qi'31"10 i..t\llS"' f,n1SIUS ,-Y1100.-.,,,...
e responses ma e herein are true and correct. Q(o I ?4 t10(~
Signature of Owner or Authorized Agent Date
FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ________________________________ _
BY· DATE· I I
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTY-HMO* APCD COUNTY-HMO APCD COUNTY-HMO APCD
*A stamp m this box only exempts busmesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply.
HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division
LIST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO
DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION •
Check all that apply:
AUTOMOTIVE
D Battery Manufacturing/Recycling
D Boat Yard
D Car Wash
D Dealership Maintenance/Painting
D Machine Shop
D Painting
D Radiator Shop
D Rental Yard Equipment
D Repair/Preventive Maintenance
D Spray Booth
D Transportation Services
D Wrecking/Recycling
CHEMICAL HANDLING
D Agricultural supplier/distributor
D Chemical Manufacturer
D Chemical Supplier/Distributor
0 Coatings/Adhesive
D Compressed Gas Supplier/Distributor
D Dry Cleaning
D Fiberglass/Resin Application
D Gas Station
D Industrial Laundry
D Laboratory
D Laboratory Supplier/Distributor
0 Oil and Fuel Bulk Supply
D Pesticide Operator/Distributor
CHEMICAL HANDLING
D Photographic Processing
D Pool Supplies/Maintenance
0 Printing/Blue Printing
D Road Coatings
D Swimming Pool
D Toxic Gas Handler
D Toxic Gas Manufacturer
METAL WORKING
D Anodizing
D Chemical Milling/Etching
D Finish-Coating/Painting
D Flame Spraying
D Foundry
D Machine Shop-Drilling/Lathes/Mills
D Metal Plating
D Metal Prepping/Chemical Coating
D Precious Metal Recovery
D Sand Blasting/Grinding
D Steel Fabricator
D Wrought Iron Manufacturing
AEROSPACE
D Aerospace Industry
D Aircraft Maintenance
D Aircraft Manufacturing
OTHERS AND MISCELLANEOUS
□ Asphalt Plant
D Biotechnology/Research
D Chiropractic Office
D Co-Generation Plant
D Dental Clinic/Office
D Dialysis Center
D Emergency Generator
D Frozen Food Processing Facility
D Hazardous Waste Hauler
D Hospital/Convalescent Home
D Laboratory/Biological Lab
D Medical Clinic/Office
D Nitrous Oxide (NO,J Control System
D Pharmaceuticals
0 Public Utility
D Refrigeration System
D Rock Quarry
D Ship Repair/Construction
D Telecommunications Cell Site
D Veterinary Clinic/Hospital
D Wood/Furniture Manufacturing/Refinishing
ELECTRONICS
D Electronic Assembly/Sub-Assembly
D Electronic Components Manufacturing
D Printed Circuit Board Manufacturing
NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES.
ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE
HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880.
LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES
Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District.
CHEMICAL
47 -Organic Gas Sterilizers
32 -Acid Chemical Milling
33 -Can & Coil Manufacturing
44 -Evaporators, Dryers & Stills Processing
Organic Materials
24 -Dry Chemical Mixing & Detergent Spray
Towers
35 -Bulk Dry Chemicals Storage
55 -Chrome Electroplating Tanks
COATINGS & ORGANIC SOLVENTS
27 -Coating & Painting
37 -Plasma Arc & Ceramic Deposition Spray
Booths
38 -Paint, Stain & Ink Mfg
27 -Printing
27 -Polyester Resin/Fiberglass Operations
METALS
18 -Metal Melting Devices
19 -Oil Quenching & Salt Baths
32 -Hot Dip Galvanizing
39 -Precious Metals Refining
ORGANIC COMPOUND MARKETING
{GASOLINE, ETC}
25 -Gasoline & Alcohol Bulk Plants & Terminals
25 -Intermediate Refuelers
26 -Gasoline & Alcohol Fuel Dispensing
COMBUSTION
34 -Piston Internal -Combustion Engines
13 -Boilers & Heaters (1 million BTU/hr or larger)
14-/ncinerators & Crematories
15 -Burn Out Ovens
16 -Core Ovens
20 -Gas Turbines, and Turbine Test Cells & Stands
48 -Landfill and/or Digester Gas Flares
ELECTRON/CS
29 -Automated Soldering
42 -Electronic Component Mfg
FOOD
12 -Fish Canneries
12 -Smoke Houses
50 -Coffee Roasters
35 -Bulk Flour & Powered Sugar Storage
SOLVENT USE
28 -Vapor & Cold Degreas·Ing
30 -Solvent & Extract Driers
31 -Dry Cleaning
ROCK AND MINERAL
04 -Hot Asphalt Batch Plants
05 -Rock Drills
06 -Screening Operations
07 -Sand Rock & Aggregate Plants
08 -Concrete Batch, CTB, Concrete Mixers, Mixers
&Silos
10-Brick Manufacturing
OTHER
01 -Abrasive Blasting Equipment
03 -Asphalt Roofing Kettles & Tankers
46 -Reverse Osmosis Membrane Mfg
51 -Aqueous Waste Neutralization
11 -nre Buffers
17 -Brake Debonders
23 -Bulk Grain & Dry Chemical Transfer & Storage
45 -Rubber Mixers
21 -Waste Disposal & Reclamation Units
36 -Grinding Booths & Rooms
40 -Asphalt Pavement Heaters
43 -Ceramic Slip Casting
41 -Perlite Processing
40 -Cooling Towers -Registration Only
91 -Fumigation Operations
56 -WWTP (1 million gal/day or larger) & Pump
Station
NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITTING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION
CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600.
HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division