HomeMy WebLinkAbout2701 Loker Ave W; 150; CBC2019-0312; Recyclea.f City of coNsTRucT10N wAsTe
C~l b d RECE:: MA~AG~:~NTPLAN ar s a Jl;N 2 s 2019
fjLJfLUff\.C L V I
Development Servic~s
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
Many of the materials generated from your project can be recycled. You are required to list materials t hat will be
reused, recycled or disposed from your project. If you have questions about the recycling requirement or completing
t his form, please contact Waste Management at (760) 929-9400, a certified C&D recycler, or the Carlsbad Building
Division at (760) 602-2700. Please note: Un~ss_you are self-haulin Waste Mana ement or a rayed haulers m~t be
used for all construction projects within the City of Carlsbad.
PART 1 Complete and submit ,his form when applying ,or a Building Permit. Note: Permits will not be issued
without a completed Construction Waste Management Plan.
Applicant Information .
Permit No. ______________ Project Title
Project Address 2701 LoRer Avel/\,ue Su~te 1s0
Applicant Name Wlt\Lte C.ol/\,s.trnchol/\,
Last First
Applicant Address 2524 c;citewci!:1 R.oCld, C.CIY'Ls.bcid, C.A 92003
Owner
0
APN
Contractor Architect Other
® 0 0
Phone .___J-_b_0~_3_3_1_.1_1_3_0 ______ E-mail Address 1/\,Cl l/\,Ctj@WlttLtecol/\,S.trnctLol/\,LV\,C,.CO_V\,l ___ ------
Applicant Mailing Address ___ _
(if different than project address)
Project Type
(check oil that apply):
Brief Description
Project Size 4,050 s.f
Residential
□
(square footage)
Please check the appropriate box:
Commercial g Public Building □ Industrial □
Estimated Cost of Project $ _____________ _
! I I plan on using WASTE MANAGEMENT roll-off bin(s) for all materials and will provide all receipts after construction.
~ I plan on self-hauling to a certified recycling facility and will provide all receipts after construction.
D This is a proposed LEED certified project and I plan on separating materials on site in conjunction with WASTE
MANAGEMENT.
Acknowledgement: I certify under penalty of perjury under the laws of the State of California that the information
provided in and with this form pertains to construction and demolition debris generated only from the project listed
in PART 1, that I have reviewed the accuracy of the information, and that the information is true and correct to the
best of my knowledge and belief.
Print Name NCll/\,C!:1 youl/\,g --Pr~ject Signature~ ~~ _____ Date bl2g'/1~
MCll/\,Clger-w ltt~te c.ol/\,s.tructLol/\, ~
Page 1 of 4 Rev. 11112/18
PART 1 Complete, obt?in sign 1ture, and subrr it th•s form when apply, 1g for a Guilding Permit. Note: Permits will
(cont'd) not be issued without a completed Con~truction Waste Management Plan.
DEBRIS RECYCLING ESTIMATE:
SECTION A Permit No. _________ Project Title
Project Address :2701 Lof<.ev Ave111,ue sui,Le 150
Applicant Name wltli,te CoV\,stvue,ti,oV\,
Last First
APN
Phone ( 7h0 ) '.)31.1130
SECTION B Complete the following table with estimated waste tonnage to be generated by your project.
This is your plan for construction waste management. Changes can be made on the final recycle report.
Goal: the diversion rate shall be 65% by weights of debris.
Material Type
Complete this line of the table only if
only using WASTE MANAGEMENT
roll-off bins.
Mixed C&D Debris
Asphalt & Concrete
Brick / Masonry/ Tile
Mixed Inert Debris
Cabinets, Doors, Fixtures,
Windows (circle all that apply)
Car et
Carpet Padding/ Foam
Cardboard
Ceiling Tile (acoustic)
Drywall (used, new, scrap)
Landscape Debris (brush, trees,
stumps, etc.) No dirt.
Une?inted Wood & Pallets
Roofing Materials
Sera Metal
Stucco
Other:
TOTAL
SECTION C
Estimated
Waste Quantity
(tons)
To meet 65% Diversion Requirement (estimate)
A B C
Place a ( ✓) check
next to items to be
reused or salvaged
Place a ( ✓) check next Place a ( ✓) check next
to items to be to items to be
recycled disposed at landfill
)C
X
X
X 0.65 = 1j t0V\,S ---------· tons
Total Estimated Waste from above Minimum Required Diversion
Contractor/Owner Signatur~ o~ ~ Date
Page 2 of 4 Rev. 11112/18