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Home My WebLink About2422 UNICORNIO ST; ; CBR2021-3792; Recycle. {_ City of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Development Ser.vices Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov Many of the materials generated from your project ca n be recycled. You are req uired to list materials that will be reused, recycled or disposed from your project. If you have questions about the recycling req uirement or complet ing this form, please contact Waste Management at (760) 929-9400, a certified C&D re cycler, or the Ca rlsbad Building Division at (760) 602-2700. Please note: Unless you are self-hauling, Waste Management or approved haulers must be used for all construct ion projects within the City of Carlsbad. PART 1 Complete and submit this form when applying for a Building Permit. Note: Permits will no! be issued without a completed Construction Waste Management Plan. Permit NoC:az:202..I -3 7 CJ 2.. Project Title Project Addre:-Z'-42-2-~c..pt..Jp Applicant Name ~"1-/Nc:ei{.., ~-, ~ l Other □ Last First Phone (310) 3€,~ -~'7/Z--E-mailAddress ---¼ ~~ Applicant Mailing Address -~-------------------------------- (if different than project address) Project Type (check all that apply): Brief Description Project Size ____________ Estimated Cost of Project $ -:Z.. s:--Q ~ --- (square footage) Please check the appropriate box: ~Ian 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 tn ...... """"nrmation is true and correct to the bestof my~gea~ Print Name ~ Signature . Date tJ/~ 2'~ fl-;,, ~o~ Page 1 of 3 Rev. 2.10.21 PArlT 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 M anagement Plan. DEBRIS RECYCLING ESTIMATE: SECTION A Permit No. _________ Project Title ProjectAddrJ--~ ~ Applicant Name ~ c· Last First ~ APN Phone 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. 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) Carpet Carpet Padding/ Foam Cardboard Ceiling Tile (acoustic) Drywall (used, new, scra p) Landscape Debris (brush, trees, stumps, etc.) No dirt. Unpainted Wood & Pallets Roofing Materials Scrap Metal Stucco Other: TOTAL SECTION C Goal: the diversion rate shall be 65% by weights of debris. = Estimated Waste Quantity (tons) .. A B C Place a (0) check next to items to be reused or salvaged □ □ □ □ □ □ □ □ □ □ □ □ ~ □ □ □ Place a (0) check next Place a (0) check next to items to be to items to be recycled disposed at landfill □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ To meet 65% Diversion Requirement (estimate) I , Co i x 0.65 = _______ J.{_._f_-? __ tons < ~oted Wo~m oho.- Contractor/Owner Signature ~ ~ Date Minimum Required Diversion (L :;?eJ-Z!:?z. Page 2 of 4 Rev. 11/12118 Conversion Table for Common Construction Waste This document is informational onlv. It is here to help vou convert truckload quantities to tons. if necessarv. Column A Column B Column C Category Material Volume TonsLUnit Tons Mixe d 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 \~0 sq ft X 0.00175 =O,o1 Building Materials (cabinets, doors, windows, etc.) l cy X 0.15 = . ,r Cardboard (flat) cy X 0.05 = Carpet By square foot ,;oo sq ft X 0.0005 = 0.1s By cubic yard cy X 0.30 = Carpet Padding/Foam l,;:; eJ 0 sq ft X 0.000125 = n, 17 Ceiling Tiles Whole (palletized) l cy X 0.0003 = Loose l cy X 0.09 = Drywall (new or used) 1/2" (by square foot) L1~0 sq ft X 0.0008 = l. 'i 't 5/8" (by square foot) sq ft X 0.00105 = Demo/used (by cu. yd.) cy X 0.25 = Land scape Debris (brush, trees, etc.) cy X 0.15 = Asphalt Composition Shingles, asphalt Shingle t 5' cy X 0.22 = ~ .. 3 Unpainted Wood/Pallets By board foot ~ bd ft X 0.001375 = By cubic yard cy X 0.15 = I Trash/Garbage ,o cy X 0.18 = l Is> Other (estimated weight) I cy X estimate = I cy X estimate = ' cy X estimate = ' cy X estimate = Total all = ·1. eoer 1"0 .. v7 Page 3 of 3 Rev. 2.10.21 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 penalt y 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 t he accuracy of t he information, and that the information is true and correct to the best of my knowledge and belief. Permit No. C::B,,'"2--~ -~7-1 :z,..Jrint Name Address dt= ~°Z:?:= l Wc~o ~ - 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 avai lable if necessary. Use City Conversion Table to convert volume to tons. Date Example: 01/05/2018 Material Type Concrete (broken) □TOTAL A Actual Amt Reused or Salvaged B Actual Amt Recycled 5 tons z. C Actual Amt Disposed in Landfill Destination Facility (Name, Address, Phone) Palomar Transfer Station, 5960 El Camino Real -{760) 603-0153 ~ Diversion Rate Achi eved _ _!::=.._t....::!...___.d-==~::2.-=-..:..z_<L.__'= .. C:-a % ::;6s%0 DIVERSION Contractor/Owner Signature;;;;;:--"""':R"'-5i~:+=~~-z;:~c:::::-Date /lfc;?V -3~ ~---- 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 Rev. 5/612022 PALOMAR TRANSFER 5960 EL CAMINO REAL CARLSBAD , CA 92008 ~D 54 Ticket #: 2409906 .(760) 603-0153 000999 -CASH AND CHECK CUSTOMER ADDRESS carlsbad, CA 92008 Contract : RESI -GATE Yr . 2 GROSS 12 ,320 Scale In TARE 9 ,640 Tare Out NET 2 ,680 Tracking Qty : 0 .00 Qty 1. 34 Un i t Description TN MSW Origin : CARLSBAD Signatu re : 100% Weighmaster : c i sneadl I n : Out : Vehicle: Ref : BOL : J une 01 , 2022 June 01 , 2022 A66041 INBOUND CASH Rate $87 .54 Extension $117 .30 Tax $0 .00 Total Paid Change .EDI T CARD -SCALE 9 :56 am 9 :56 am Total $117 .30 $117 .30 $117 .30 $0 .00 V PAL()tMR Ti½tt~FER STA 5960 EL CAMINO REAL CARLSBAD, CA 92008 06/01/2022 09:57:10 <:Nd # 01\) C~d: AID: SEQ #: Batd, #: INVOICE Awoval Code: Entry Melhod: Mode: CREDIT CARD VISA SAl.f ~4212 VISA DEBIT A0000000031010 23 278 24 005712 01\) Read Issuer SALE AMOUNT 117.30 CUSTOMER COPY PALOMAR TRANSFER 5960 EL CAM I NO REAL CARLSBAD , CA 92008 _( 7 6 0 ) 6 0 3 -0 15 3 000999 -CAS H AND CHECK CUSTOMER ADDRESS carlsbad, CA 92008 Contract : RESIDENTIAL-Yr . 2 GROSS 12 ,320 TARE NET 9 ,820 2 ,500 Tracking Qty: 0 .00 Qty 1.25 Unit Description TN MSW Origin : CARLSBAD Signature : Scale In Scale Out 100% 54 Ticket #: 23987 47 Weighmaster : cisneadl In : Out : Vehicle : May 04 , 2022 May 04 , 2022 CD Ref : 12 ,320 BOL : 160CC INBOUND CASH Rate $83 .04 Extension $103 .80 Tax $0.00 Total Paid Change .EDIT CARD-SCALE 1 :42 pm 2:00 pm Total $103.80 $103 .80 $103 .80 $0 .00 V / P~lOM}& T~_NSF~R ,ST A 5960 EL CAMINO REAL . CARLSBAD, cI 92000 ·05/04/2022 :_ 14:02:47 CREDIT CARD VISA COMPLETED SALE Card # Chip Card: AID: SEQ #: ORIG PRE·AUTH SEQ #: Bat.ch #: INVOICE <ioroval Code: ~!hod: ~l'ILE AMOUNT XXXXXXXXXXXX4212 VISA DEBIT A0000000031010 44 1080 250 44 094316 Ch~ Read Issuer $103,80 CUSTOMER COPY \ PALO~R T~NSFER 5960 EL CAMINO REAL CARLSBAD , CA 92008 (760) 603-0153 000999 -CAS H AND CHECK CUSTOMER ADDRESS carlsbad, CA 92008 Contract : RESI -GATE Yr . 2 GROSS 13 ,320 TARE NET 9 ,640 3 ,680 Tracking Qty : 0 .00 Qty 1. 84 Unit Description TN MSW Scale In Tare Out 54 Ti cket #: 2403077 Weighmaster : venegem I n : Out : Ve h icl e : Ref : BOL : INBOU ND CASH May 15, 2022 May 15, 2022 A66041 Rate Extension $83 .04 $152 .79 Tax $0 .00 Origin : CARLSBAD 100 % Signature : Total Paid Change .EDIT CARD-SCALE 8 :29 am 8 :29 am Total $152 .79 $152 .79 $152 .79 $0.00 V . ' P#.:OMAR WiNSFER STA 5960 EL CAMINO REAL CARLSBAD, CA 92008 05/15/2022 08:29:54 '3d # Ol~ '3d: AID: SEQ #: Batch ii: INVOICE ~oval Code: Enlry Method: Mode: CREDIT CARD VISA SALE X'ffti.'ttftftl..4 212 VISA DEBIT A0000000031010 10 261 10 042911 ~~tless Issuer SALE AMOUNT 152.79 CUSTOMER COPY