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HomeMy WebLinkAbout2873 Trails Ln; ; CB153208; Recycle· {cicyof -Carlsbad RESIDENTIAL GREEN BUILDING CODE STANDARDS MANDATORY MEASURES CERTIFICATION CHECKLIST Development Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov 8-51 . This form, signed and completed, and all receipts for the recycled materials shall be · ·· submitted to the Building Inspector prior to Final Inspection. , ' ,, . .. • ,• '"' ' • " , , '<l , , ' Site Development Mandatorv 4.106.2 A plan is developed and implemented to manage storm water drainage during construction. (X) 4.106.3 The site shall be planned and developed to keep surface water away from buildings. (X) Construction plans shall indicate how site grading or a drainage system will manage all surface water flows. Energy Efficiency 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by (X) the California Energy Standards. Water Efficiency and Conservation Indoor Water Use 4.303.1 Indoor water use shall be reduced by at least 20 percent using one of the following methods: {X) 1. Water saving fixtures or flow restrictors shall be used. 7/01/2011 2. A 20 percent reduction in baseline water use shall be demonstrated. 4.303.2 When using the calculation method specified in Section 4.303.1, multiple showerheads shall not (X) exceed maximum flow rates. 7/01/2011 4.303.3 Plumbing fixtures (water closets and urinals) and fitflngs (faucets and shower heads) shall (X) comply with specified performance requirements. 7/01/2011 Outdoor Water Use 4.304.1 Automatic irrigation systems controllers installed at the time of final inspection shall be weather-{X) based. Enhanced Durability and Reduced Maintenance 4.406.1 Joints and openings. Annular spaces around pipes, electric cables, conduits or other openings in plates at exterior walls shall be protected against the passage of rodents by closing such openings (X) with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. Construction Waste Management Plan 4.408.1 A minimum of 65 percent of the construction waste generated at the site is diverted to recycle or (X) salvage. Recycled material receipts from approved recyclers must be attached to this form. 4.408.2 Where a local jurisdiction does not have a construction and demolition waste management (X) ordinance, construction waste management plan, per form B-59, shall be submitted for approval to the enforcina anencv. Building Maintenance and Operation 4.410.1 An oneration and maintenance manual shall be orovided to the buildina occu=nt or owner. (X) Environmental Quality Fireplaces 4.503.1 Any installed gas fireplace shall be a direct-vent sealed-combustion type. Any installed woodstove or pellet stove shall comply with US EPA Phase II emission limits where applicable. {X) Woodstoves, oellet stoves and fireolaces shall also comolv with annlicable local ordinances. 8-51 Page 1 of 2 Rev. 5/17 Pollutant Control 4.504.1 Duct openings and other related air distribution component openings shall be covered during construction. {X) 4.504.2.1 Adhesive, sealants and caulks shall be compliant with VOC and other toxic compound (X) limits. (X) 4.504.2.2 Paints, stains and other coatings shall be compliant with voe limits. (X) 4.504.2.3 Aerosol paints and coatings shall be compliant with product weighted MIR limits for ROC and other toxic compounds. (X) 4.504.2.4 Documentation shall be provided to verify that compliant voe limit finish materials have been used. (X) 4.504.3 Carpet and carpet systems shall be compliant with voe limits. 4.504.4 50 percent of floor area receiving resilient flooring shall comply with VOC-emission limits (X) defined in the Collaborative for High Performance Schools (CHPS) Low-emitting Materials List or be certified under the Resilient Floor Covering Institute (RFC!) FloorScore program. (X) 4.504.5 Particleboard, medium density fiberboard (MDF) and hardwood plywood used in interior finish svstems shall comolv with low formaldehyde emission standards. Interior Moisture Control 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. (X) 4.505.3 Moisture content of building materials used in wall and floor framing is checked before (X) enclosure. Indoor Air Quality and Exhaust 4.506.1 Exhaust fans which terminate outside the buildina are provided in every bathroom. IX\ Environmental Comfort 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the fan is off. Covers or louvers shall have a minimum insulation value of R-4.2. (X) 4.507.2 Duct systems are sized, designed, and equipment is selected using the following methods: (X) 1. Establish heat loss and heat gain values according to ACCA Manual J or equivalent. 2. Size duct systems according to ACCA 29-D (Manual D) or equivalent 3. Select heatina and coolino eouipment accordina to ACCA 36-S (Manual S) or eauivalent. Installer and Special Inspector Qualifications . 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. (X) 702.2 Special inspectors employed by the owner must be qualified and able to demonstrate comoetence in the discioline thev are inspecting. (X) I, as the professional responsible for this project, certify that, to the best of my knowledge, the mandatory items listed on this form have been incorporated into the project in order to comply with Title 24, Part 11 of the 2016 California Green Building Standards. All receipts for recycled materials have been attached to this form. CB153136, CB153197, CB153206, CB153207, CB153208. CB153209, 2881, 2887, 2673, 2869, 2660, 2864, 2868, 2872, 2876, 2880, 2864, 2888 TRAILS LANE CARLSBAD, CA 92008 CB153202, CB153203, CB153204, CB153205, CB153201. CB153200, Project Address: 3151, 3155 DONNA DRIVE CARLSBAD, CA 92008 Plan Check Number: CB153199, CB153198 Print Name: DAN HAYDEN Signed: ~ D: License Number: ,,.r~~ Date: /;_?l-!Jh~Q B-51 Page 2 of 2 Rev. 5/17 ' WASTE MANAGEMENT DUMPSITE/LANDFILL Palomar Landfill (PAL) 5960 El Camino Real Carlsbad CA 92008 ' ' DATE OF SERVICE SVC TICKET# 1/29/2018 935238 3/1/2018 944719 3/27/2018 953393 4/10/2018 958117 4/17/2018 960376 4/23/2018 961976 4/23/2018 961975 5/10/2018 967557 5/22/2018 972331 6/13/2018 978846 6/13/2018 978845 6/20/2018 981129 6/29/2018 973608 7/3/2018 985721 7/10/2018 987751 7/27/2018 994426 7/27/2018 994424 9/6/2018 7282 9/22/2018 13597 10/1/2018 16431 10/9/2018 18392 10/10/2018 19094 10/10/2018 19095 10/11/2018 20201 10/12/2018 20202 10/12/2018 20204 10/15/2018 20205 10/16/2018 20206 10/17/2018 21284 12/3/2018 36487 12/3/2018 36488 1/8/2019 47753 1/25/2019 53946 2/12/2019 58620 2/26/2019 62554 3/6/2019 65181 3/8/2019 6518S 3/13/2019 67190 3/21/2019 69504 3/27/2019 71322 4/4/2019 74670 4/9/2019 754S2 4/9/2019 75450 4/19/2019 79231 4/23/2019 79829 4/26/2019 81292 GENERAL CONTRACTOR: PACUFUCA REAK ESTATE SERVICES 3151 DONNA DR CARLSBAD CA 92008 Construction & Recycling Services 5701 S. Eastern Ave., STE 300, Commerce, CA 90040 714-480-2317 (Direct) 866-459-3985 (Fax) C&D SORT & TRANSFER FACILITY EDCO CDI Recycling & Buy Back Center 224 5 Las Posas Rd Acct: 350-72372 Sales Rep: Victoria Brown-Delgado bdorman@pacificaent.com Prepared Date· 12/03/2019 San Marcos CA 92078 ' Total Tons RECY BIN SIZE MATERIAL TYPE Tons RCY RATE% FACILITY 40YD MIXED DEMO 9.03 7.49 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 13.05 10.83 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 17.75 14.73 83.00% EDCO SAN MARCOS (EDD) 40YD TRASH/ MSW 13.52 0.00 0.00% PALOMAR LANDFILL (PAL) 25YD TRASH/ MSW 2.54 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD TRASH/ MSW 5.80 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MDODYS MATERIALS (MOO) 40YD TRASH/ MSW 2.83 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 40YD TRASH/ MSW 6.80 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD TRASH/ MSW 2.71 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD TRASH/ MSW 4.52 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD TRASH/MSW 3.01 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 40YD TRASH/ MSW 5.52 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 40YD TRASH/ MSW 3.04 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 40YD TRASH/ MSW 9.19 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 40YD TRASH /MSW S.39 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD TRASH/ MSW 10.36 0.00 0.00% PALOMAR LANDFILL (PAL) lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 40YD MIXED DEMO 5.60 4.65 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 4.03 3.34 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 5.22 4.33 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 4.10 3.40 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 4.07 3.38 83.00% EDCO SAN MARCOS (EDD) 40YD TRASH/ MSW 3.31 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD MIXED DEMO 4.07 3.38 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 3.82 3.17 83.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 3.94 3.47 88.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 2.42 2.13 88.00% EDCO SAN MARCOS (EDD) 40YD TRASH/MSW 2.28 0.00 0.00% PALOMAR LANDFILL (PAL) 40YD MIXED DEMO 3.21 2.82 88.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 2.38 2.09 88.00% EDCO SAN MARCOS (EDD) 40YD MIXED DEMO 2.82 2.48 88.00% EDCO SAN MARCOS (EDD) 40YD TRASH/ MSW 1.68 0.00 0.00% PALOMAR LANDFILL (PAL) 4/29/2019 81572 40YD MIXED DEMO 4.29 3.78 88.00% EDCO SAN MARCOS (EDD) ' 5/7/2019 84270 40YD TRASH/MSW 2.35 0.00 0.00% PALOMAR LANDFILL (PAL) 5/13/2019 86132 40YD MIXED DEMO 3.50 3.08 88.00% EDCO SAN MARCOS (EDD) 5/20/2019 88949 40YD MIXED DEMO 3.11 2.74 88.00% EDCO SAN MARCOS (EDD) 5/24/2019 90209 40YD TRASH/MSW 2.09 0.00 0.00% PALOMAR LANDFILL (PAL) 5/25/2019 90517 40YD MIXED DEMO 2.96 2.60 88.00% EDCO SAN MARCOS (EDD) 6/3/2019 92232 40YD MIXED DEMO 2.98 2.62 88.00% EDCO SAN MARCOS (EDD) 6/3/2019 92234 40YD TRASH/MSW 1.93 0.00 0.00% PALOMAR LANDFILL (PAL) 6/10/2019 94769 40YD MIXED DEMO S.09 4.48 88.00% EDCO SAN MARCOS (EDD) 6/13/2019 96232 40YD MIXED DEMO 0.90 0.00 0.00% PALOMAR LANDFILL (PAL) 6/17/2019 96889 40YD MIXED DEMO S.18 4.56 88.00% EDCO SAN MARCOS (EDD) 6/24/2019 99027 40YD TRASH/ MSW 0.95 0.00 0.00% PALOMAR LANDFILL (PAL) 6/24/2019 99026 40YD MIXED DEMO S.87 5.17 88.00% EDCO SAN MARCOS (EDD) 6/27/2019 100802 40YD MIXED DEMO 5.23 4.60 88.00% EDCO SAN MARCOS (EDD) 6/28/2019 101235 40YD TRASH/MSW 0.90 0.00 0.00% PALOMAR LANDFILL (PAL) 7/1/2019 101519 40YD MIXED DEMO 4.76 4.19 88.00% EDCO SAN MARCOS (EDD) 7/3/2019 102923 lOYD TRASH/ MSW 5.76 5.07 88.00% EDCO SAN MARCOS (EDD) 7/3/2019 102795 40YD TRASH/ MSW 1.56 0.00 0.00% PALOMAR LANDFILL (PAL) 7/8/2019 103334 lOYD TRASH/ MSW 6.87 0.00 0.00% PALOMAR LANDFILL (PAL) 7/8/2019 103329 40YD MIXED DEMO 4.66 4.10 88.00% EDCO SAN MARCOS (EDD) 7/8/2019 103331 lOYD MIXED DEMO 7.32 6.44 88.00% EDCO SAN MARCOS (EDD) 7/10/2019 104695 40YD MIXED DEMO 0.55 0.48 88.00% EDCO SAN MARCOS (EDD) 7/11/2019 104844 lOYD TRASH/ MSW 5.67 0.00 0.00% PALOMAR LANDFILL (PAL) 7/11/2019 104695 40YD TRASH/ MSW 1.57 0.00 0.00% PALOMAR LANDFILL (PAL) 7/12/2019 105339 40YD MIXED DEMO 2.73 2.40 88.00% EDCO SAN MARCOS (EDD) 7/16/2019 105192 lOYD TRASH/MSW 5.34 0.00 0.00% PALOMAR LANDFILL (PAL) 7/22/2019 107916 40YD TRASH/MSW 0.62 0.00 0.00% PALOMAR LANDFILL (PAL) 7/22/2019 105983 40YD TRASH/MSW 1.16 0.00 0.00% PALOMAR LANDFILL (PAL) 7/25/2019 109455 lOYD TRASH/ MSW 5.33 0.00 0.00% PALOMAR LANDFILL (PAL) 7/25/2019 107469 lOYD TRASH/ MSW 3.84 0.00 0.00% PALOMAR LANDFILL (PAL) 7/29/2019 109974 40YD TRASH/ MSW 1.20 0.00 0.00% PALOMAR LANDFILL (PAL) 7/29/2019 109454 40YD MIXED DEMO 3.04 2.68 88.00% EDCO SAN MARCOS (EDD) 7/31/2019 110729 40YD MIXED DEMO 4.42 3.89 88.00% EDCO SAN MARCOS (EDD) 8/2/2019 112068 lOYD TRASH /MSW 2.19 0.00 0.00% PALOMAR LANDFILL (PAL) 8/6/2019 112560 40YD TRASH /MSW 0.94 0.00 0.00% PALOMAR LANDFILL (PAL) 8/6/2019 112559 40YD TRASH/ MSW 2.47 0.00 0.00% PALOMAR LANDFILL (PAL) 8/7/2019 113778 40YD MIXED DEMO 2.96 2.60 88.00% EDCO SAN MARCOS (EDD) 8/9/2019 114306 lOYD TRASH/ MSW 6.76 0.00 0.00% PALOMAR LANDFILL (PAL) 8/12/2019 114601 lOYD TRASH/ MSW 5.39 0.00 0.00% PALOMAR LANDFILL (PAL) 8/15/2019 116183 40YD TRASH/ MSW 2.01 0.00 0.00% PALOMAR LANDFILL (PAL) 8/15/2019 116184 lOYD TRASH/ MSW 5.43 0.00 0.00% PALOMAR LANDFILL (PAL) 8/20/2019 117094 lOYD TRASH/ MSW 3.30 0.00 0.00% PALOMAR LANDFILL (PAL) 8/21/2019 118104 lOYD TRASH/ MSW 7.30 0.00 0.00% PALOMAR LANDFILL (PAL) 8/23/2019 119293 lOYD TRASH/ MSW 7.62 0.00 0.00% PALOMAR LANDFILL (PAL) 8/23/2019 119460 40YD TRASH/ MSW 3.94 0.00 0.00% PALOMAR LANDFILL (PAL) 8/26/2019 119579 lOYD TRASH/ MSW 9.46 0.00 0.00% PALOMAR LANDFILL (PAL) 8/27/2019 119869 lOYD TRASH/ MSW 4.12 0.00 0.00% PALOMAR LANDFILL (PAL) 8/27/2019 4316 lOYD CL CONCRETE 10.00 10.00 100.00% MOODYS MATERIALS (MOO) 9/4/2019 121411 lOYD TRASH/ MSW 6.42 0.00 0.00% PALOMAR LANDFILL (PAL) 9/5/2019 122502 40YD MIXED DEMO 1.62 1.43 88.00% EDCO SAN MARCOS (EDD) 9/6/2019 123061 40YD TRASH/ MSW 3.36 0.00 0.00% PALOMAR LANDFILL (PAL) 9/11/2019 123786 lOYD TRASH/ MSW S.37 0.00 0.00% PALOMAR LANDFILL (PAL) 9/25/2019 128006 40YD TRASH/ MSW 4.09 0.00 0.00% PALOMAR LANDFILL (PAL) 10/4/2019 131432 40YD TRASH/ MSW 2.36 0.00 0.00% PALOMAR LANDFILL (PAL) 10/4/2019 131433 40YD MIXED DEMO 1.21 1.06 88.00% EDCO SAN MARCOS (EDD) 10/7/2019 131434 lOYD TRASH/ MSW 7.31 0.00 0.00% PALOMAR LANDFILL (PAL) 10/18/2019 136251 lOYD TRASH/ MSW 4.36 0.00 0.00% PALOMAR LANDFILL (PAL) 10/18/2019 135048 40YD TRASH/ MSW 2.64 0.00 0.00% PALOMAR LANDFILL (PAL) 10/24/2019 137273 40YD MIXED DEMO 1.28 1.13 88.00% EDCO SAN MARCOS (EDD) 10/29/2019 138835 40YD TRASH/ MSW 1.30 0.00 0.00% PALOMAR LANDFILL (PAL) 11/1/2019 140440 lOYD TRASH/ MSW 6.98 0.00 0.00% PALOMAR LANDFILL (PAL) 11/4/2019 140726 40YD MIXED DEMO 1.01 0.89 88.00% EDCO SAN MARCOS (EDD) 11/5/2019 141106 40YD TRASH/ MSW 1.63 0.00 0.00% PALOMAR LANDFILL (PAL) 11/7/2019 109975 lOYD TRASH/ MSW 5.49 0.00 0.00% PALOMAR LANDFILL (PAL) 11/14/2019 143937 40YD TRASH/ MSW 1.19 0.00 0.00% PALOMAR LANDFILL (PAL) 11/26/2019 148149 40YD MIXED DEMO 1.53 1.35 88.00% EDCO SAN MARCOS (EDD) Total Tons 564.78 Total Tons Diverted 303.04 Total Tons Landfilled 261.74 Total Diversion 53.66% {city of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Deve_/gpme11tJe_rvice_s Building Division 1635 Faraday Avenue 760-602-2719 www.car/sbadco.gov Many of the materials generated from your project can be recycled. You are required to list materials that will be reused, recycled or disposed from your project. If you have questions about the recycling requirement or completing this 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: Unless you are self-hauling, Waste Management or approved haulers must be used for all construction projects within the City of Carlsbad, PART 1 Complete and submit this form when applying for a Building Permit. Note: Permits will not be issued without a completed Construction Waste Management Plan. Applicant Information CB153136, CB153197, CB153206, CB153207, CB153208. CB153209, CB153202, CB153203. C8153204, Permit No.ca1s3205. ce1sa201. cs153200. ca153199. ca1sa19a Project Title _T,_,RA--"--'l,.,,L,..,'Se...,,E,,__N,.,D,_ ______________ _ Project Address 3151 DONNA DRIVE CARLSBAD, CA 92008 APN 1560910100 Owner Contractor Architect Other Applicant Name __,H__,,A2Y_,__D"'-'=E,..,Nc..._ ____ _,D,,,A;;,,N~------- Last First © © 00-- Applicant Address 5505 CANCHA DE GOLF RANCHO SANTA FE CA 92091 Phone ( 858 l 755 -0216 E-mail Address DHAYDEN@PACIFICAENT.COM Applicant Mailing Address 5505 CANCHA DE GOLF RANCHO SANTA FE, CA 92091 (if different than project address) Project Type (check all that apply/: Brief Description Residential Commercial [Kl □ TWIN HOME SINGLE FAMILY FOR SALE Publlc Building □ Project Size 336,808 SQUARE FEET (square footage) Estimated Cost of Project $_~1~0~0~0~0~0~0~0 ___________ _ Please check the appropriate box: @1 plan on using WASTE MANAGEMENT roll-off bin(s) for all materials and will provide all receipts after construction. DI 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 DAN HAYDEN Slgnature, _ _:~'::::===c:i,_,-~J___...::;!~==:...._Date .{ ... (2.:, Page 1 of 4 Rev. 11/12118 PART 1 Complete, obtain signature, and submit this form when applying for a Building Permit. Note: Permits wil (cont'd) not be issued without a completed Construction Waste Management Plan. DEBRIS RECYCLING ESTIMATE: SECTION A CB153136, C8153197, CB153206, CB153207, CB153208, C8153209, CB153202, CB153203, CB153204, Permit Noce1s32os. ce153201, ce1s3200, ce1531ss, ce1531ssProject Title TRAIL'S END Project Address 3151 DONNA DRIVE CARLSBAD, CA 92008 APN 1560910100 Applicant Name HAYDEN DAN Phone ( 858 755 -0216 Last SECTION B Material Type Complete this fine of the table onfy if only using WASTE MANAGEMENT rofl~off bins. Mixed C&D Debris MASONRY BLOCK CONCRETE (BROKEN) UNPAINTED WOOD DRYWALL ROOF TILE LATH CARDBOARD WIRE METAL PIPE INSULATION TILE STUCCO MISC. RECYCLING TRASH TOTAL SECTION C Estimated Waste Quantity (tons) 188.23 33.53 27.50 28.00 10.37 17.94 12.67 2.80 2.80 2.80 2.80 28.68 8.81 197.67 : 564.78 To meet 65% Diversion Requirement (estimate) First A B Place a(✓) check next to items to be reused or salvaged Place a ( ✓) check next to items to be recycled X X X X X X X X X X X X X C Place a ( ✓) check next to items to be disposed at landfill X _ ___-5._.6=-:4.:.:.7__::8:.._ ___ x 0.65 =-____ ___-3 .. 6c.:7.:._.1:....1:.._ __ tons Total Estimated Waste from above Minimum Required Diversion Contractor/Owner Signature C=:::-:, ~~ Date Page 2 of4 Rev. 11/12118 PART 2'' Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final building approval. DEBRIS RECYCLING REPORT (ACTUAL): SECTION A 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. Permit No. C fJ IS' 3'?.C>8' Print Name DAN HAYDEN Address 1..87'!, T r._,\s '""" <. CARLSBAD, CA 92008 [¢\-I° Date 0 SECTION B Use this Final Log below to track loads of materials as they leave the job site. ©>©>SAVE RECEIPTS©>©> Indicate FINAL quantities in tons for each material and save receipts and documents from facilities where material is taken. Additional Project Log pages are available if necessary. Use City Conversion Table to convert volume to tons. A B C Date Material Type Actual Amt Actual Amt Actual Amt Destination Facility Reused or Recycled Disposed in (Name, Address, Phone) Salvaged Landfill Exam12.le: Palomar Transfer Station, 5960 El 01/05/2018 Concrete {broken) 5 tons Camino Real -760 603-0153 1/29/18-3127/18 MASONRY BRICK (BROKEN) 0 1.99TONS 0TONS EDCO SAN MARCOS 224 S LAS POSAS RD 1/29/18-3/27/18 CONCRETE(BROKEN) 0 0.37 TONS OTONS EOCO SAN MARCOS 224 S LAS POSAS RD 1/29/18-3/27/18 MASONRY BRICK (BROKEN) 0 9.11 TONS 0TONS MOODY'S MATERIALS 3210 OCEANSIDE BLVD 1/29/18-3/27118 CONCRETE (BROKEN) 0 1.61 TONS OTONS MOODY'S MATERIALS 3210 OCEANSIDE BLVD Diversion Rate Achieved --------~-----------_____ % 2: 65% :,,65%0 Total of columns A + B Total of columns A+ B + C DIVERSION Contractor/Owner Signature __ \==:::::-.,='..._,_l"t__::~l-===----'Date \ / g / '2-o '1v Attach the following documentation to this Report: Return completed form and documentation to: Original recycling weight tickets, landfill weight tickets Original donation receipts with photos and/or itemized descriptions Any other relevant information to support Recycling Report City of Carlsbad Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 Page 3 of4 Rev, 11/12/18 PART 2 Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final building approval. DEBRIS RECYCLING REPORT (ACTUAL): SECTION A 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 DAN HAYDEN Permit No. ( (j If 1 l..O~ Address 1,87) T,,. ... ;I~ L ...... t CARLSBAD CA 92008 Lo} ~ Date \ A B C , .,·.,J::-·;f/i·.i~V.·.,;:✓;._.,·· ... • _ .--• .. • ... · f 11tJlft,ljs,wf!l!f il:maI11r1a1. is i~keni. I~ t.ci ccinveiti!IO!ume. to tons. · Date Material Type Actual Amt Actual Amt Actual Amt Destination Faclllty (Name, Address, Phone) Example: 01/05/2018 1/08/19-6/03/19 1/08/19-6/03/19 1/08/19-6/03/19 1{08/19-6/03/19 1/08119-6/03/19 Concrete (broken) UNPAINTED WOOD DRYWALL ROOF TILE LATH CARDBOARD Reused or Salvaged 0 0 0 0 0 Recycled Disposed In Landfill 5 tons 1.12TONS 0TONS 0.67 TONS OTONS 0.45TONS OTONS 0.89TONS DTONS 0.69TONS OTONS Palomar Transfer Station, 5960 El Camino Real -760 603-0153 EOCO SAN MARCOS 224 S LAS POSAS RD EDCO SAN MARCOS 224 S LAS POSAS RD EDCO SAN MARCOS 224 S LAS POSAS RD EDCO SAN MARCOS 224 S LAS POSAS RD EDCO SAN MARCOS 224 S LAS POSAS RD Diversion Rate Achieved ________ _, ___________ = _____ % ~ 65% S6S%0 Total of columns A+ B Total of columns A + B + C DIVERSION Contractor/Owner Signature! ___ ~'..:===iiU,b~====----Date \/8 J 7,.:; -Z.o Attach the following documentation to this Report: Return completed form and documentation to: Original recycling weight tickets, landfill weight tickets Original donation receipts with photos and/or itemized descriptions Any other relevant information to support Recycling Report City of Carlsbad Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 Page 3 of 4 Rev. 11/12118 PART 2 Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final building approval. DEBRIS RECYCLING REPORT (ACTUAL): SECTION A 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. Permit No. g / S-1 -Z. D S--Print Name DAN HAYDEN Address 2 l! ,'} Tr-.... l S Lo..,,.e CARLSBAD CA 92008 L O J. S" Date A Date Material Type Actual Amt Reused or Salvaged B/27/19 STUCCO 0 6103/19-9/05/19 STUCCO 0 6/03/19-9/05/19 UNPAINTED WOOD 0 6/03/19-9105/19 DRYWALL 0 6103/19-9105/19 ROOF TILE 0 6/03/19-9/05/19 LATH 0 6/03/19-9/05/19 "-'RE 0 6/03/19-9/05/19 METAL PIPE 0 6/03/19-9/05/19 INSULATION 0 6/03/19-9/05/19 TILE 0 6/03/19-9/05/19 MISC. RECYCLING 0 Actual Amt Recycled 0.71 TONS 0.99TONS 0.49 TONS 0.99TONS 0.17TONS 0,17 TONS 0.17TONS 0.17TONS 0.17TONS 0.17 TONS 0.26 TONS Jh11y l!ffiVt:tlfct'Job site. ; ,,;c· ," .... ·· o~ f~itlfl<if~ti~re mat~rial is taken. on.TaJ:ii~~ifi.\ifii:ti'i'0l11rne IC!. foris. C Actual Amt Destination Facility Disposed in (Name, Address, Phone) Landfill 0TONS MOODY'S MATERIALS 3210-GCEANSIDE BLVD 0TONS EOCO SAN MARCOS 224 S LAS POSAS RO 0TONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EOCO SAN MARCOS 224 S LAS POSAS RO OTONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EDCO SAN MARCOS 224 S LAS POSAS RD OTONS EDCO SAN MARCOS 224 S LAS POSAS RO Diversion Rate Achieved --------~ ----------~= _____ % ~ 65% sGs%0 Total of columns A + B Total of columns A + B + C DIVERSION Contractor/Owner Signature c=:::::::-,.., L') Date \ / g / ?.o "lP Attach the following documentation to this Report: Return completed form and documentation to: Original recycling weight tickets, landfill weight tickets City of Carlsbad Original donation receipts with photos and/or itemized descriptions Any other relevant information to support Recycling Report Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 Page 3 of4 Rev. 11112118 PAJ!T 2 Complete. before final inspection, obtain WASTE MANAGEMENT signature, and return with reeeipts prior to final building approval. DEBRIS RECYCLING REPORT (ACTUAL): ~FrTION A 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. Permit No. (B Ir ) 1.. 0 S:: Print Name DAN HAYDEN Address '2-lf 7 A T ro-; Is L..,.,-< CARLSBAD, CA 02008 L,,1-S-Date ... µ~~tth~ri~ilf~t>t·~.l9\'ll.totracl<•,oac1s 0{11lj1teH•t,as.i1tey.•lea,i,•tf1e.j9ij,slt •. .. . . . ... . . . . . . @@SAVE RECEIP'l'S®@ .·· .... . . . . . . . lndtcateflNAt•c:jtiaili1t.1e~'lnti:irts,hit.ea~h in:~ter1a1·and.save.•re:te)p~•aoddoi:um~nts·from·fal:ilitles.wherematerl~l•IS.taken. • ··MiM1rlr\\i1~~.b~~~t~gpa~J~ aie·~vail~~1e· ,,.ii~~~s$arv, ·u~e·c,ty CQ'1~ts1onra\ll!i.t(i.!:ll\1i/~.~()l~tneto.w11s. A B C Date Example: 0J/05/2018 9/0C/l9-l 1/2!W19 9/06/1 ~11126119 1129/19-11/26/f9 Material Type Concrete /broken} UNPAINTeO WOOQ CARDBOARD ROOF TILE TRASH Actual Amt Reused or Salva ed u 0 0 0 0 Actual Amt Actual Amt Destination Faclflty Recycled Disposed In {Name, Address, Phone) Landfill Polomur rrans/et Statton, 3960 Ef 5 tOl)S Cam/no Real -760 603-0153 0.01 TONS OTONS EOCO SAN MARCOS 224 S LAS POSA$ RO 0.06TONS OTONS EDCO SAN MARCOS224 S l.AS POSAS RO 0.2S'f0NS OTONS EPCO $AN M-'RCOS 224 S lAS POSAS RC 0 18.7 TONS PALOMAR TAASNFER STATION 6900 EL CAMINO REAL 21.6 TONS . 18.7TONS Diversion Rate A!:hieved 21.6 TONS / __ 4_0_.3~TO_N_S~. __ = 53.66 % ;t 65% :.65%0 Totdl of tolvmn$ A+ B Total of columns A+ B+ C DIVERSION Contractor/Owner Signature ~ ~ Date \ /!/ 1.o lo Attach the following documentation to this Report: Return completed form and documentation to: • Original recycling weight tickets, fantlfill wei1ht tlci<ets City of Carlsbad • Original donation receipts with photo, and/or Itemized descriptions Building OivlSion (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 • Any other rele~nt Information to support RecycUng Report Pa1111 3 of 4