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HomeMy WebLinkAbout2701 LOKER AVE W; 235; CBRA2020-0461; Recycle' Ccityof Carlsbad CONSTRUCTIOIN WASTE MANAGEMENT PLAN B-59 Development Services Building Division 1635 Farodoy Avenue 760-602-2719 City wof'Cf~'iffl'~ov J/1.N 2 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 ~'fi._rtl)tlli/i, ii>IVd~fQ\:j,,g 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 Permit No. CBB20~C)-O'--\lp\ Project Title Ns-JE.:>f\lJI: l DE-MO..A-r\ON C:w'---¼ I\ ~ q:2.010 ProjectAddress ;:r)O\ lo\<£:~ b<VE '.l'-\D 1?,5D 1::f1O (A€,LSy,e.t>,0.-APN qpq-O'B\ -:l:l.·CO ~ Owner Contractor Architect Other ApplicantName ,\12!>n~-S:.o1\1tiN O O O © ]5)b" Last First Applicant Address 3123.'o Cof<"\1 ~Q ::Re:1.:Z,e t-l,. . ~ ~'2. s~"t61;-c..o I CI/>, C\1.\~ Phone r "'°' l 10~-o;,'&> E-mail Address e_iQ$:t,"SC.t5tt<?..bhdo.iQC:, COl'V) Applicant MailingAddress (if different than project address) Project Type (check all that apply): Resldential □ Commercial Kl Public E!uilding □ Brief Description 4\..,ul.!~ ..... g ... ,.,QR...,,,,,,_J)e,roo--""'"""-'-""'l..1:"':'rt'-'--'0"'\,.:l""'--_,,,O""-'~""-"L:"-;--t--'---.,-------------------- Project Size \\.,\ 1 '::\S:~ (square footage) Please check the appropriate box: Estimated Cost of Project$_(e~':)-,.~QCO=-~•-P _________ _ DI 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. Signature_--iC-=-~=~===~---'Date Page 1 of4 Rev. 11112118 PART 1 Complete, obtain signature, and submit this form when applying for a Building Permit. Note: Permits will (cont'd) not be issued without a completed Construction Waste Management Plan. DEBRIS RECYCLING ESTIMATE: Lost First • , 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 tabfe only if only using WASTE MANAGEMENT roll-off bins. Mixed C&D Debrls Asphalt & Concrete Brick/ Masonry/ TIie Mixed Inert Debris Cabinets, Doors, Fixtures, Windows (circle all that apply) Carpet Carpet Padding/ Foam Cardboard Ceiling Tile (acoustic} Drywall (used, new, scrap) landscape Debris {brush, trees, stumps, etc.} No dirt. Unpainted Wood & Pallets Roofing Materials Scrap Metal Stucco Other: TOTAL • Estimated Waste Quantity (tons) Lf to,)r To meet 65% Diversion Requirement {estimate) Contractor/Owner Signature ~ A Place a (0) check next to items to be reused or salvaged B Place a (0) check next to items to be recycled C Place a (0) check next to items to be disposed at landfill I TaJJ II __ J__.i.j'--Lr_,,'-',J,c'l':___X 0.65 =-___ ?.::_;! ______ tons Totped Waste from above {z Date Minrmum Required Diversion ' f , Page 2 of4 Rev. 11112/18 ( I PART 2 Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final building approval. DEBRIS RECYCLING REPORT (ACTUAL): 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. ________________ Print Name Address Date __________________________ D,ate Material Type A Actual Amt Reused or Salvaged B C Actual Amt Actual Amt Recycled Disposed In Landfill Destination Facility (Name, Address, Phone) Example: 01/05/2018 Concrete {broken) 5 tons Palomar Transfer Station, 5960 El Camino Real -760 603-0153 Diversion Rate Achieved ________ J ___________ = _____ % Total of columns A+ B Total of columns A+ B + C DIVERSION Contractor/Owner Signature _______________ Date 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 Building Division (1st Floor) Any other relevant information to support Recycling Report 1635 Faraday Avenue Carlsbad, CA 92008 Page 3 of 4 Rev. 11/12118 ' Conversion Table for Common Construction Waste This document is informational onlv. It is here to helo vou convert truckload auantities to tons if necessarv. Column A Column B Column C Category Material Volume Tons[Unit Tons Mixed Debris Construction cy X 0.18 = Demolition cy X 1.19 = Asphalt/Concrete Asphalt (broken) cy X 0.70 = Concrete (broken) cy X 1.20 = Concrete (solid slab) cy X 1.30 = Brick/Masonry/Tile Brick (broken) cy X 0.70 = Brick (whole, palletized) cy X 1.51 = Masonry brick (broken) cy X 0.60 = Tile sq ft X 0.00175 = Building Materials (cabinets, doors, windows, etc.) cy X 0.15 = Cardboard (flat) cy X a.as = Carpet By square foot sq ft X 0.0005 = By cubic yard cy X 0.30 = Carpet Padding/Foam sq ft X 0.000125 = Ceiling Tiles Whole (palletized) cy X 0.0003 = Loose cy X 0.09 = Drywall (new or used) 1/2" (by square foot) sq ft X 0.0008 = 5/8" (by square foot) sq ft X 0.00105 = Demo/used (by cu. yd.) cy X 0.25 = Landscape Debris (brush, trees, etc.) cy X 0.15 = Asphalt Composition Shingles, asphalt Shingle cy X 0.22 = Unpainted Wood/Pallets By board foot bd ft X 0.001375 = By cubic yard cy X 0.15 = Trash/Garbage cy X 0.18 = Other (estimated weight) cy X estimate = cy X estimate = cy X estimate = cy X estimate = Total all = Page 4 of 4 Rev. 11112/18 • • DEMOLITION ASBESTOS CERTIFICATION ADDRESS: USE OF BUILDING TO BE DEMOLISHED: SQUARE FEET _________ _ X NUMBER OF STORIES ____ _ PROPERTY OWNER: ADDRESS: PHONE APPLICANT: ADDRESS: PHONE Section 19827.5 of California Health and Safety Code states in part: "A demolition permit shall not be issued by any city ... as to any building or other structure except upon receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project." As applicant for a demolition permit in the City of Carlsbad, I certify that; I have read the excerpt from Section 19827.5 of the Health and Safety Code provided above; the information I have provided on this form is true and correct; and I further certify the following: ( ) On the attached ___ pages are copies of all written asbestos notifications regarding the above referenced building that are required to be submitted to the United States Environmental Protection Agency or to Part 61 of Title 40 of the Code of Federal Regulations, or successor to that part. ( ) I declare that the written asbestos notification is not applicable to the scheduled demolitlon project. Applicant's Signature Date Rev. 11/12118 Date: January 20, 2021 Project Name: Pacific Western Bank Diversified Destruction Co. Cutting I Coring I Demolition I Environmental I Restoration CONSTRUCTION AND DEMOLITION DEBRIS RECYCLING LOG Dally log of Construction and Demohtion (C&O) Materials removed or reused for this project Customer. WhiteConstruct1on Job No. 14525 ------------ Address: 2701 loker Avenue Carlsbad Ca DATE TICKET NO. DESTINATION LOCATION (TONS) (TONS) NET MATERIAL TYPE ,..C\'Q.OI RECYCLED TRASH TONS 0.00 0.00 0% 12/30/20 2186313 Palomar Transfer E1 Camino Re;il 0.00 4.84 0% 4.84 Trash 1/5/21 22241 Edco Transfer Dalbergia St 7.46 0.00 100% 7.46 Drywall 1/5/21 2188626 Palomar El Camino ReJII 0.00 3.47 0% 3.47 T=h 1/7/21 437327 Miller Enterprises Magnolia Ave 1.78 0.00 100% 1.78 Tin 1/7/21 2189547 Palomar Transfer El Camino Real 0.00 3.77 0% 3.77 Trash 1/8/21 2189946 Palomar Transfer El Camino Real 0.00 0.10 0% 0.1 Trash 1/8/21 22946 Edco Transfer Dalbergia St 6.61 0.00 100% 6.61 Drywall 1/13/21 23914 Edco Transfe,-Dalbergia St 7.40 0.00 100% 7.4 Drywall 1/14/21 24219 Edco Transfer Dalbergla St 4.82 0.00 100% 4.82 Drywall 1/14/21 437494 Miller Enterprises Magnolia Ave 0.98 0.00 100% 0.98 Metal 0.00 0.00 0% 0.00 0.00 0% 0.00 0.00 0% 29.05 12.18 41.23 Total Recycled 70% license #980634 PH: 619-249-S286 P.O. BOX 713040 Santee, CA 92072 . -.. .. . . -. : : . _: ..... ?::: ~. ·-. -..... : :::-.~: .::: -... ,., -. _, . i.:'~!:.!C~(!? ' ., • ' ,J -.... -=- I, t'.:llni Ttansfcr fi ta l 1On ! ,; GO :),'\ 1 ht· T g i cl SL . :::w Dic..•9 0 1 Cl\ 92136 (r,19). 2 3,; 7774 \l)"'-Y-oW ~ :,o\ v !O 'J;, c.. .,p..._,\ <,C>~ ,., I NVCTC'E 0t1'~ ! Cur:~OIO(!t': 0 ]79 Tick cL: ~2:Ml Dct. Le : 0 1 / o S / 2 : In : 14 : 50 Truck: 9999 :1 LVER!;T F TEl1 DESTRUCTION r .O .BOX ".'13040 :;ANTEE CA 92072 :• IO 1 LOCl-;F.R AVE Oul.: RutP. l~:l~ Cor..:.a1ne1·: Route: 02065 Oc ... g 1 n : O?. 0 SA.V. U.: l::GO C< imn:od i Ly 1,1, D1 ywclll 1<.iro::::s(T,~l: Un iLs 7.4 6 2~.9S co nG Sclff l Tctn~ 15. •19 ton ::i Sc lit 1 ~et: E:xtcn dcd Cha r ge 4 69.98 7 . •1 6 t o n ~) T07AL DU~ H,9. 98 Coosuucllon & Demolition Diversion Certificate •· Diversion Percentage 100% This cert1hos that the company listed above has utilized an EOCO fac,hty to oivert co1strucl1on demolrllon materials 1n accordance w:th LEED requirement. The diversion tonnage 1s based on an overaU tonnage percentage of the respective EDCO faci'ity RHOTl· ))l I Vt:-r \ FA-~~A~ -MA~3~E~ =~•: .. ::: ':~.!•:I~~~, ?E.;: :A?~S3~:, ~~ ~7 ~~: :~:?~r -~=~~~5IF:~J :E3~)~~7:~~ • , ::J --~-·r:1~. \,'!~:.:.. 'J..":~. -;:; :,.,::: .:..?E ;::.c::: 30!: ...... ,-.--- -~·'•-.I .. -: .. :='.x ~~:1S l'::•:- 32,.; . .;.; ,,:::ar:.ce s::,. J( MILLE:R ENTERPRISES • .J ., . • '.'A .""'t _ '"-•'-,'L S~llerlO or11,e1Llc M ,th·t •· 1-t r A,,'' 1 CA D..:020 ;-"( I r .. ~ • • -• f""::')•"'" ~•u1o-.. Tu,~ SU, Sit• A11 ,., I S249.20 •• l I -' I, S249 20 )( --------Seller's Signature . \ . THANK YOU. : .... · . ., -·-:..:.: .. --\, .,.,. ..... -::._ ... .-;-: __ ... __ --.. :. = .... ..,;: . . . ~:,:;i~ :1·.;c:?~::!::: :;::s::L::-:.::: :I'.~.!:.~ ?t.:::~;.~ ';:~:;.. .;•:::. --:--r.:,.--: J •• I .-::;-1-'\ \•-:,_•n : r,:-.... ... . . --·· :'J21 ... .: """ -=--... Ef'IC"O T.::annfer S::.utjon 1660 D~lb~rgia SL. ~:.in ;Jtego, CA 92136 (r:19} ~H 777'1 , ·u:; l om<:::: 0179 " "r v)'-''\L "1, ""\ \) \ Iv a\"-✓ Ticket: Date: 2291 6 o_/oa/21 n1VEx51F'TED 01::STRUCTION ;, rJ.AOX 7U0•t0 !.:ANTFI· t 'A 9?072 :!.I ll I LOCKF.!{ J\VI~ ".xnmod i ty Rate , s nry·,,al 1 ~ ,._ ln: 12:28 Out: !2: SI INVOl<.'E Truck : 9999 <.'ont:,1 _ ner: rwute: 0206~, origin: o~o s,~ Dl t-:Gc ! (~I 1_1:;:;:; ( l ll ) : Units 6 .61 2 2 . .1 l L on!l Sc 1 tr 1 1'are 1 S. ·10 ton:. :'1iin WL N~t: F.>: I., nd..-ci Charge •116 .4 ·~ 6 . b I t O:lG] TOTA.J. DUE ,,J6.4 \ Construction & Demohtion Diversion Cert1hcate •· Diversion Percentage 100"0 This certifies that the company listed above has utiltzed an EDCO facility to divert construchoo demolit10n materials in accordance •,•11th LEED requirement. The divers10n tonnage 1s based on an overall tonnage percentage ol thc respective EDCO fac1hty. RROT E Drivt=-1 \ :-:!>C.'O T!cmsfer St:aLion .H,GO Da ~.bcrg~il St:. .=-:.-111 !ht:-qo, CA 92136 (o'il9) ~l.J -777<1 w \A \ \-\.. -z,:1 u\ LC\(t. .. -A <: C \AvL.~-8 -A() .-.··.1!;Lo 11.e1·: 01.79 Ticket: ~HVf-:H~~ I FIED DESTRUCTIOll 11 .O HGX 7 130,10 !;ANTEE CA 9:~07:? /·10 I LO<'KER AV'£ Date: ,·:l!lcnud1ry Un1L!; ,,,, fh-ywcill 7.40 23914 01/13/:>l RdLC Tn: 11: 08 Out: 11: 29 --, Truck. Con::aincr: RouLt:: 0 1igin: INVOICE 9999 020§5 020 "'!;AN DlEG(l I-,xti:.11, I C'h,i ''l'J ,1 {, (, .• ! (• 1c:n,:;i:!ln): :U.03 Lons Scl:ll Tare lS.63 tons Sclhl Net: 7. 40 t.onsl TOTAL DUE 4 r.,&. ~r• Co11struc11on & Demotrtion Diversion Certificate • • Orversion Percentage 100% This cert.hes that the company listed above has ulililed an EDCO facility to divert construction c!emol1tion materials in accordance w•th LEED requirement. The diversion tonnage rs based on an overall tonnage percentage of the respective E0CO facihty. 28OT;-; Otiver \ i-::>CO Tt,mi:ftc-r SL,1t1on 16~0 DDlbcrq.1.a SL. :;,111 l;1•·go, CA 921 35 t ,,.i 9 l . .:! H -rn -1 ',.J"' ,\. '-p,.-~ "\(<~- " "'"\O\ \_.\l \ t:,ltO (.\I>-.,._ "> t\1::Lomc1·: 0179 Tick et.: 24219 Date: 01/1'1/21 In: 14:H Out:: 14 : '.'?8 ffiVEHSTFIED DI:.::.n'HJ(."l'!UN P 0. HOX "/130~0 .:;~TEI:: Cl\. 9:1 0'1:~ .'. 0 l I.OCKER AVE ('omntccij Ly Un.1.L!.: ~r, ~~ywall 4.82 RaLC.• lNVO l I•: Tn.:ck: 9999 Container: Routr>: 0206'., Origin: 020 S/l.N :1 11-:,.:n Extend~ 1 ('l1,11·q1.: \ W L f;i; 1c~1·n.::-;(Tn): 20.~1 Lo ns Sclltl Tare 15.69 LOr.s Scl#l Ncl: :; . 82 tOll!:;J TOTA:, DUE \0 ! t',{, Construction & Demolition Diversion Ccrt,hcate •· D1vers1on Percentage 100% ri,,~ cer11fies that the company listed above has utilized an EDCO facility lo divert construd1on dernol1t1on materials in accordance w1ltl LEED requirement. The d1vers1on lonnage is based on an overall tonnage percentage of the respective EDCO iacdity 1:-mo·:·t•: --Driver \ ~ 111111111 ,,,, ',> ,117 4G4 •.·s,,:7;.~ ·,t~;'A MILLER ENTERPRISES, -J?o I lCJt..e ~ Seifer 10 32331 OrlverLic L,::>\..., ~ C 1;.,._ ,,,), , :...-11/~RS~~:Ev M-111,ri.il CitOfiti, T;H,rp Veh Plate N•t -:,,:-•.,_:, - J.;~; .:ti$'2:",':Y S105.88 $105.88 x---,--,--------Seller's Signature