HomeMy WebLinkAbout2424 UNICORNIO ST; ; CBR2022-1008; RecyclePART 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. C2:JZ-.~-I~ Print Name
Address °?4::"2--L\:: l_?Jc ,~2) S±::.
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.
Date
Example:
01/05/2018
Material Type
Concrete (broken)
□TOTAL
Diversion Rate Achieved
A B C
Actual Amt
Reused or
Salvaged
Actual Amt Actual Amt
Recycled Disposed in
Landfill
5 tons
Destination Facility
(Name, Address, Phone)
Palomar Transfer Station, 5960 El
Camino Real
-(760} 603-0153
~ s6s%0
I of columns A + B + C DIVERSION
~
Contractor /Owner Signature'=-""~-SL_1.~:3.::_.t.~~i,;,,,,,,.__"--_Date >--fol "3o ~z.........__
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
(760)603-0153
000999 -CASH AND CHECK CUSTOMER
ADDRESS
carlsbad, CA 92008
Contract : RESI -GATE Yr . 2
GROSS 12,520
TARE 9 ,640 .
I NET 2 ,880
, Tracking Qty: 0 .00 ,,,
Qty
1. 44
Unit Description
TN MSW
Scale In
Tare Out
'°' 4 T i ck et # : 2 4 4 4 3 5 5
Weighmaster: aceveos
In:
Out :
Vehicle :
Ref :
BOL :
August 20 , 2022
August 20 , 2022
A66041
INBOUND
CASH
Rate
$87 .54
Extension
$126 .06
Tax
$0 .00
Origin: CARLSBAD 100%
Signature :
Total
Paid
Change
.EDIT CARD-SCALE
9 :00 am
9 :00 am
Total
$126 .06
$126.06
$126.06
$0.00
V
PALOMAR TRANSFER SJA .•
5960 EL CAMINO REAL
CARLSBAD, CA 92008
08/20/2022 09:00:56
Card #
Ch~ Card:
AID:
SEQ #:
Batch #:
INVJICE
Ap~oval Code:
Er.fly Melhod:
Mode:
CREDIT CARD
VISA SALE
XXXXXXXXXXXX4 212
VISA DEBIT
A0000000031010
25
358
26
050012
Chip Read
Issuer
SAlE AMOUNT
CUSTOMER COPY I
PALOMA"R Tk:~NSFER
§960 EL CAMINO REAL
CARLSBAD, CA 92008
_(760) 603-0153
000999 -CASH AND CHECK CUSTOMER
ADDRESS
carlsbad, CA 92008
Contract : RESI -GATE Yr. 2
GROSS 15,540
TARE 9 ,640
NET
Tracking Qty :
5 ,900
0.00
Qty
2.95
Unit Description
TN MSW
Scale In
Tare Out
:-1,1 Ticket #: 2405640
Weighmaster: rivernol
In:
Out :
Vehicle :
Ref :
BOL :
INBOUND
CASH
May 21 , 2022
May 21 , 2022
A66041
Rate Extension
$83 .04 $244 .97
Tax
$0.00
Origin: CARLSBAD 100%
Signa ture :
Total
Paid
Change
.EDIT CARD -SCALE
9:01 am
9 :01 am
Total
$244 .97
$244 .97
$244.97
$0.00
V
PALCMAR TRANJFER STA
5960 EL CAMINO REAL
CARLSBAD, CA 92008
05/21/2022 09:01:36
card#
Ch~ Card:
AID:
SEQ#:
Bat.ch #:
INVOICE
Approval Code:
Entry Melhod:
Mode:
CREDIT CARD
VISA SALE
XXXXXXXXXXXX4 212
VISA DEBIT
A0000000031010
11
267
11
060112
Contact~ss
Issuer
SAlE AMOUNT $244,97
CUSTOMER COPY
MATERIALS, INC.
1610 Melrose W ay
Vista, CA 92081
Bill To
TD Development
1550 Via Allondra
San Marcos, CA 92078
Item Service Date Freight Bill #
Super-JO 2/26/2022 41844
Dump Fees 2/26/2022 41844b
Super-I 0 2/26/2022 7402419
Dump Fees 2/26/2022 7402419b
~
All trucking billed hourly/ all dump fees billed by the load.
Phone # I 76075833 18 I Fax # I
Invoice
Date Invoice #
2/28/2022 I 0508
~
?4ZZ-~ ~
(>lcic.F:>A-J ~
P.O./ Job No. Terms Due Date
2422 Unicomio St Csbd Net30 3/30/2022
Class Qty Rate Amount
Joseph 2 120.00 240.00
Dirt Dump Fee I 60.00 60.00
Wyatt 3.8 120.00 456.00
Dirt Dump Fee 2 60.00 120.00
o/ )¥1~ r({
~' \1 ,\ J V 411 I/
. 1/JJ C
fl~
Total $876.00
760-758-3504 I E-mail acct@josephmaterials.com
CA# 4€1828
~
TRUCKING, INC.
SHIPPING ORDER ANO FREIGHT BILL
JOSEPH TRUCKING, INC.
1610 Melrose Way
Vista, CA 92081
Office: 760 758-3318 Fax: 760 758-3504
j osep htrucking.com
OVERLYING CARRIER -~EPH MATERIALS, INC.
coNslGNOR 1:0 u~ ✓ e Io f N'1 :e" ~
CONSIGNEE------------------------
DEDUC-
TIONS
CHARGEABLE
HOURS
JOB#
PRECISE POINT
HRS
MIN
□HRS
□MIN
□HRS
O TNS
O YDS O LDS
O TNS
O YDS OLDS
O TNS
41844
OATE ,J·J..L~
RATE CHARGES
OF ORIGIN -mc..=-L..!..L..J-..,e:::....,,-L~..U.-4o"--,._w._,,"-"-__._..._. ........ ~""-=:....:....::..__...J....=:..:c..::....:.....=.:..::..::___:=c::..._----....L-----L----------□MIN O YDS O LDS
PlANT PLANT STAND JOB JOB STAND CONSIGNEE/ PRECISE POINT OF WEIGHT KIND OF DEL NET
IN OUT BY IN OUT BY DESTINATION TICKET MTL ZONE WEIGHT RATE AMOUNT
NO OR MllfS TNS/YDS
liO IJ/lJ 1;)1./() tJ~t; ~ailt--. o .rnl.11c. -
tin -' J -~"' /"\ -) -_---......... y I ) ) I' r-i l k.:_U (/ .>. I/ )H-X-l
~I / ~ l '
~ ~ ', .,
DELAY TIME APPROVAL /f:,.rz::_-P' ~o '"'5UJ~ SIGNATURE I I \.,VLLC\.,
CONSIGNOR -CONSIGNEE / / DRIVER
Debtor agrees to pay legal fees and court costs for collection of delinquent accounts, also, legal rate of Interest for past due account balances. Not responsible for damage resulting
from delivery made ALL CHARGES DUE NO LATER THAN THE TWENTY -FIFTH OF THE MONTH FOLLOWING THE DATE OF THIS FREIGHT BILL
WHITE -BILLING CANARY -BILLING PINK -JOB GOLDENROD -JOB
inside the curb or property line.
r
ptllllf u~m,
01q1
s :>1
\lO
UNOE
(IF ANY) MA.TEIUALSINC At3~~ WAY VISTA, CALIFORNIA 92081
ii SUPER-10
□s
2
3
4
5
6
7
8
9
10
11
12
13
14
15
□ E MP
SIOEDUMP
0 TRUCK&PUP
□ WATER TRUCK
RUNNll'IG TIMP. LAIT TRIP
PH. q
PH
RECEIVER
CllY/STATE/ZIP
POINT OF DESTINATION
□ FLATBED
O MIXER
0 SWEEPER
□ OTHER ____ _
NET TIME TOTAL TONS
CA#
9 HOURLY O Ti~ ~LOAD
RATE@$ l).._/ ....:...=----
ECEIVER (AGENT OR DEBITOR) SIGNATURE