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Home My WebLink About1015 CHESTNUT AVE; CS; CBC2022-0129; PermitBuilding Permit Finaled Commercial Permit Print Date: 03/02/2023 Job Address: 1015 CHESTNUT AVE, # CS, CARLSBAD, CA 92008-2563 Permit No: Status: (city of Carlsbad CBC2022-0129 Closed -Finaled Permit Type: BLDG-Commercial Work Class: Tenant Improvement Parcel#: Valuation: Occupancy Group: #of Dwelling Units: 2051902501 Track#: $0.00 Lot#: Project#: Plan#: Bedrooms: Construction Type: Bathrooms: Orig. Plan Check#: Occupant Load: Plan Check#: Code Edition: Sprinkled: Project Title: Description: AT&T WIRELESS; MODIFICATION TO EXISTING CELL SITE FEE BUILDING PLAN CHECK BUILDING PLAN REVIEW-MINOR PROJECTS (LDE) BUILDING PLAN REVIEW -MINOR PROJECTS (PLN) ELEC: OTHER COMPLEX ELECTRICAL FIRE Special Equipment (Ovens, Dust, Battery) Total Fees: $1,429.80 Total Payments To Date: $1,429.80 Applied: 04/22/2022 Issued: 07/11/2022 Finaled Close Out: 03/02/2023 Final Inspection: 02/23/2023 INSPECTOR: Kersch, Tim Contractor: BECHTEL INFRASTRUCTURE AND POWER CORPORATION 12245 KIRKHAM RD, # STE 100 POWAY, CA 92064-6162 (949) 372-4503 Balance Due: AMOUNT $267.80 $194.00 $98.00 $412.00 $458.00 $0.00 Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as 11fees/exaction.11 You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Building Division Page 1 of 1 1635 Faraday Avenue, Carlsbad CA 92008-7314 \ 442-339-2719 \ 760-602-8560 f \ www.carlsbadca.gov ( City of Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Check C.BC.. '292.2.-01 ~ Est. Va I u e RJt,p(e,£ Ii 1,1',t ~.(r PC Deposit Date 7 -11 • 'l.. 02,..2... Job Address 1015 Chestnut Avenue Suite:_D_3 ___ APN: 205-190-25-12 Tenant Name:_A_T_&_T_W_i_re_le_s_s ___________ Lot#: Year Built:_1_98_4 ___ Occupancy:_B_-2 ___ _ Construction Type:..· V:...•..:B::...... __ _,fire Sprinklers:~ ~A/C:~ ~ BRIEF DESCRIPTION OF WORK: Modification to an existing wireless facility. D Addition/New: ___________ New SF and Use, ___________ New SF and Use, ____ Deck SF, Patio Cover SF (not including flatwork) ~ Tenant lmprovement:_3_02_.5_6 ___ SF, Existing Use_W_C_F _____ Proposed Use _W_C_F ____ _ _____ SF, Existing Use Proposed Use ______ _ D Pool/Spa:. _____ SF Additional Gas or Electrical Features? ____________ _ □□ □□ □□ D Solar: ___ KW, ___ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No □ Plumbing/Mechanical/Electrical Only: U •-· C ,-1 \!I': r~, ---------------lnbil--1,,t-_-<-r.-;--'.,,'-la-... "". 1f-ll,.j,,_i-4[i",'--. tl-.J+---- [!] Other: Wireless facility JUL 11 2022 This permit is to be issued in the name of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the owner or contractor. The person listed as the Applicant below will be the main paint of contact throughout the permit process. PROPERTY OWNER Name: The Markos & Melpo Voulgaris Family Trust Address:4769 Niaqara Avenue APPLICANT O PROPERTY OWNERS AUTHORIZED AGENT APPLICANT ~ Name: Christine Strileckis, MD7 LLC Address: 10590 West Ocean Air Drive Suite 250 City: San Diego State:_C_A __ .Zip: 92107 City: San Diego State:_C_A __ .Zip: 92130 Phone: Phone: 858-964-7403 ----------------- Email: cstrileckis@md7.com Email: cstrileckis@md7.com DESIGN PROFESSIONAL APPLICANT 0 CONTRACTOR BUSINESS APPLICANT 0 Name: MD7 Architecture Services, Inc. Name: Bechtel Infrastructure & Power Address: 10590 West Ocean Air Drive Suite 250 Address: 12245 Kirkham Road, Suite 100 City: San Diego State: CA Zip:_9_21_3_o __ City: Poway State: CA Zip:_9_2_0_6_4 ___ _ Phone: Phone: 619-943-2462 Email: Email: jzepeda1@bechtel.com Architect State License: ___________ State License:_9_1_3_04_5 ____ Bus. License: ______ _ 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 1 of 2 Email: Building@carlsbadca.gov Rev. 08/20 IDENTIFY WHO WILL PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW: (OPTION A): LICENSED CONTRACTOR DECLARATION: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. Policy No. ________________________ _ Ii] I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Company Name: ACE AMERICAN INSURANCE COMPANY Policy No. WLRC68916847 Expiration Date: ;.:Oc_4cc/0"1;.:/2;.:0cc23'-------------------- 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name:. _____________________ Lender's Address:--------------------~ CONTRACTOR PRINT: Jocelyn Zepeda SIGN: (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the /of/owing reason: Zepeda. Jocelyn (JZEPEDA1) DI, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). DI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: D "Owner Builder acknowledgement and verification form" has been filled out, signed and attached to this application. Proof of identification attached. D Owners "Authorized Agent Form" has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner' behalf. Proof of identification attached. By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors./ understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leginfo.ca.gov/calaw.html. OWNER PRINT: ____________ SIGN: _________ .DATE: ______ _ APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL By my signature below~ I certify that: I am the property owner or State of California Licensed Contractor or authorized to act on the property owner or contractor's behalf. I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SA VE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. APPLICANT PRINT: Christine Strileckis 01<J,t•l11s,goodbyChnsur.e 0411912022 SIGN: _.;.:.:_...:,if;;j/;;."· __ :_~.~_:_~22_0_"_"_''-''-""_'_00_·, DATE: 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov B-2 Page 2 of 2 Rev. 08/20 Building Permit Inspection History Finaled ( City of Carlsbad PERMIT INSPECTION HISTORY for (CBC2022·0129) Permit Type: BLDG-Commercial Application Date: 04/22/2022 Owner: TRUST COX FAMILY 2001 TRUST Work Class: Tenant Improvement Status: Closed -Finaled 12-19-01 Issue Date: 07/11/2022 Subdivision: PARCEL MAP NO 12574 Expiration Date: 08/22/2023 IVR Number: 40181 Address: 1015 CHESTNUT AVE, # CS CARLSBAD, CA 92008-2563 Scheduled Actual Inspection Type Inspection No, Inspection Primary Inspector Reinspection Inspection Date Start Date Status 02/2312023 02/23/2023 BLDG-34 Rough 204048-2023 Passed Tim Kersch Thursday, March 2, 2023 Electrical Checklist Item BLDG~Building Deficiency NOTES Created By Angie Teanio COMMENTS TEXT 760-717-8571 Corey BLDG-Final Inspection 204049-2023 Passed Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final NOTES Created By Angie Teanio COMMENTS TEXT 760-717-8571 Corey Tim Kersch Passed Yes Created Dale 02/22/2023 Passed Yes Yes Yes Yes Yes Created Date 02122/2023 Complete Complete Page 1 of 1 M SQUAR{t.J~ WIRELESS_,. Site Name Site Number Client Proposed Carrier Site Location Structure Tvoe Structural Usage Ratio Overall Result Structural Analysis AT&T April 12, 2022 Carlsbad SD0475 MD7 AT&T 1015 Chestnut Ave #d3 Carlsbad, CA 92008 33.15806 N NAD83 -117.33892 WNAD83 Eauioment Room 103.7% Pass CITY Upon reviewing the results of this analysis, it is our opinion that the structure does meet the specified IBC/ ASCE/TIA code requirements. The equipment room framing is therefore deemed adequate to support the existing and proposed loading as listed in this report. MSQ~ 1 387 CALLE AVANZADO. SAN CLE CBC2022-0129 1015 CHESTNUT AVE #CS AT&T WIRELESS MODIFICATION TO EXISTING CELL SITI 2051902501 4/22/2022 CBC2022-0129 M SQUARl!r-)~ WIRELESS.,.. Summary of Contents Introduction Opening Statement Project Description Criteria Conclusion Calculations Appendix A Design Tables & Resources Used Assumptions and Limitations Our structural calculations are completed assuming all information provided to M SQUARED WIRELESS is accurate and applicable to this site. For the purposes of calculations, we assume an overall structure condition of "like new" and all members and connections to be free of corrosion and/or structural defects. The structure owner and/or contractor shall verify the structure's condition prior to installation of any proposed equipment. If actual conditions differ from those described in this report M SQUARED WIRELESS should be notified immediately to complete a revised evaluation. Our evaluation is completed using standard TIA, AISC, ACI, and ASCE methods and procedures. Our structural results are proprietary and should not be used by others as their own. M SQUARED WIRELESS is not responsible for decisions made by others that are or are not based on our supplied assumptions and conclusions. Page I M SQUAR&•,~ WIRELESS-' INTRODUCTION At the request of AT&T, M SQUARED WIRELESS has performed a structural analysis for the proposed modifications. All supporting documents have been obtained from the client and are assumed to be accurate and applicable at this site. Supporting Documentation I Antenna Loading I MD7, Construction Drawings, Dated: 03/30/22 Analysis Code Requirements Wind Speed 96 mnh (Vult) Wind Sneed w/ ice 30 moh (3-Second Gust) w/ 0" ice TIA Revision ANSI/TIA-222-H Adooted IBC 2018 IBC / 2019 CBC Structure Class 2 Exoosure Cate1wrv C Topograohic Categorv I Calculated Crest Hei!!ht 0 CONCLUSION Upon reviewing the results of this analysis, it is our opinion that the structure does meet the specified IBC/ASCE/TIA code requirements. The equipment room framing is therefore deemed adequate to support the existing and proposed loading as listed in this report. Page2 M SQUARU-l1 WIRELESS-' Final Configuration Mount Qty. Height (ft) 6 3 Equipment Room 3 3 3 3 Structure Usages Microlam 2X6 2-2X4 RATING= Appurtenance -48V DC Power Plant w/ (2) New Strings of Batteries Batterv Rack w/ (16) Batteries 1.037 .609 .600 103.7% RBS 3206 19" Rack Fiber Cabinet 23" LTE Rack AC Mount Type Carrier -AT&T Page 3 Equipment Room Load -48V DC Power Plant w/ (2) New Strings of Batteries Battery Rack w/ (16) Batteries RBS 3206 19" Rack Fiber Cabinet 23" LTE Rack AC DL LL Equipment Room Framing Plan I I I I I I I I I I ti i I I I I I I r;-i, ~ (t) 1:zoof I r-1---1 I I jf1Jl I (W I ~i @i 00 i Weight 3000 lbs 3000 lbs 600 lbs 450 lbs 800 lbs 450 lbs 450 lbs 18 psf 50 psf Check Existing Truss J2 26" Deep Truss Span= 27'4" Trib width = 2' DL LL Equipment load from above See attached Risa Cales Existing Truss OK 14 psf 50 psf M Squared Wireless SO0475 Truss J2 Apr 12, 2022 at 11 :18 PM S00475 Truss.r3d ~ z • LOMk BLC 1, s.K W.lghl -Colt- M Squared Wireless S00475 Truss J2 Apr 12, 2022 at 11:18 PM S00475 Truss.r3d ., ...... LNCK BLC 7, S•rvto. lfW"• 1 Env•lo~ Only Solubon M Squared Wireless S00475 Truss J2 Apr 12, 2022 at 11 :18 PM $D0475 Truss.r3d IIIRISA Company Designer Job Number Model Name M Squared Wireless A NEMETSCHEK COMPANY SD0475 Member Primary Data I ,ahAI I lnjnt J Joint K Joint Rotateld•n' S•rJion/Ch ...... 1 M1 N4 N3 web retro 1 2 M2 N4 N5 woh rPlrn 1 3 M3 N6 N5 web retro 1 4 M4 NS N7 wPb rPtrn 1 5 M5 N8 N7 web retro 1 6 M6 N8 N9 ,., .. h rPtro 1 7 M7 N10 N9 web retro 1 8 M8 N10 N11 ,., .. h r Ptrn 1 9 M9 N12 N11 web retro 1 10 M10 N12 Nn ..,,.h rP.trn ? 11 M11 N1 N4 btm chord 12 M12 N4 N6 htm 13 M13 NS N8 btm 14 M14 N8 N10 htm 15 M15 N10 N12 btm 16 M16 N12 N2 htm r.hord 17 M17 N3 N5 too 18 M18 N5 N7 tnn r.hord 19 M19 N7 N9 too ?() M20 N9 N11 tnn 21 M21 N11 N13 ton Wood Material Properties I ,ohAI Tun.. c .... ,. ... ., f.:ranA 1 OF Solid Sa ... Visually ... Ooualas Fir-Larrh No.1 2 SP Solid Sa ... Visually ... ~n11thP-rn Pine No 1 3 HF Solid Sa ... Visually ... Hem-Fir No.1 4 SPF Solid Sa ... Visually ... ~nr, '""'-Pine-fir No.1 5 24F-1.8E DF .. Glulam NOS Tab .. 24F-1 .8E OF BAL na s 24F-1.8E OF .. ~h,lam NDS Tab .. 24F-1.8E OF UNBAL n::i 7 24F-1.8E SP .. Glulam NDS Tab .. 24F-1 8E SP BAL na 8 24F-1.8E SP .. Glulam NOS Tab .. 24F-1.8E SP UNBAL n::i 9 Micro SCL TrusJoist 2.2E OF/LP/WH Microllam LVL na 1.75X5.5FS Joint Coordinates and Temperatures Tun. n...jftn I jct Beam Rectanaular Be::im R0 r-tannular Beam Rectanaular B0 <>m R0 r-tannul::ir Beam R<>rtannular R<><1m R<>rt::inm •""'r Beam Rectannular R<><1m R<>rt::inn• ''"'r Beam Rectannular R<><1m R<>rt::innular Beam Rectannular Beam 1.9E Microllam .. Beam 1.9E Microllam .. Beam 1.9E Microllam .. Beam 1.9E Microllam .. Beam RP-ctanaular Beam 1.9E Microllam .. Beam Rectanaular Beam 1.9E Microllam .. Beam 1.9E Microllam .. Beam 1.9E Microllam .. C:m i:: .... nn 1 1 1 1 1 1 1 1 1 0 Apr12,2022 11:17 PM Checked By: __ Uatanal n,...,ian R11l•c OF T11nical OF Tvnical OF T11njr<>I OF Tvnjr.::il OF T11nical OF Tvoical OF T11nical OF Tvnical OF Tvnical OF Tvnical OF T11nical Micro Tvnical Mir.rn Tvnical Micro Tvnir.al Micro Tvoical OF Tvnical Micro Tvoical OF T11nir.al Micro Tvoical Micro Tvnir<1I Micro Tvoical I\J11 ThA ...... -.. ·- ,:I 3 .n:1i:; 1 3 n1i:; .3 3 .035 1 3 n1i:; .3 .3 .035 1 3 n1i:; .3 .3 .035 j .3 01", .3 .3 .035 RISA-3O Version 17.0.4 [C:\ ... \. .. \ ... \ ... \M2\2022\03 -March\SO0475\Risa3d\SO0475 Truss.r3d] Page 1 IIIRISA Company Designer Job Number Model Name M Squared Wireless A NEMETSCHEK COMPANY SD0475 Joint Coordinates and Temperatures (Continued) 7 N7 11 6 1.708333 N 14.5 N9 17.4 1.708333 1 2 .3 N11 23.2 1.708333 1 61 N13 2 70 Wood Design Parameters I ahal ~ .. ftftft I ftft_ • ._, .... .,,,., IA11ft1 18-b@nd tn l,._b@nd hn 1 M1 web retro 1 3.inR 1 1 Lbvv 2 M2 web retro 1 3 36n lbvv 3 M3 web retro 1 3.366 Lbvv 4 M4 web retro 1 3 ':ti:::i::: Lbvv 5 MS web retro 1 3.366 Lbvv 6 ui::: web retro 1 3.36n Lbvv 7 M7 web retro 1 3.366 Lbvv 8 MB web retro 1 3.':ti:::i::: Lbvv 9 M9 web retro 1 3.366 Lbvv 10 M10 web retro 2 3.':ti:::i::: I hvv 11 M11 btm chord 2 65 Lbvv 1? M12 htm 58 I hvv 13 Mn btm 58 Lbvv 14 M14 htm " J:l I hvv 15 M15 btm 58 Lbvv 16 M16 htm chord 2 i:::i-I hvv 17 M17 ton 58 Lbvv 18 M18 tnn chord " J:l I hvv 19 M19 ton 5.8 5 5 Lbvv 20 M20 tnn 58 Lhvv 21 M21 tnn 5.8 Lbvv M17 y 3 y 4 y 5 y M21 Member Area Loads Joint A Joint B Joint c Joint P No Data to Print ... DL LZ 3 Wind Load AZI 090 WLX 0 0 0 0 0 l<vu 1(77 -1328 -270 -4 Direction 0 0 0 0 0 0 r\/ Apr12,2022 11:17 PM Checked By: __ r., V ,:wav 7 .,..,.,v Yes Yes Yes Vee:: Yes yoc Yes yoc Yes yoc Yes Vpc Yes Voe YPS yoc Yes y0c Yes Yes Yee:: Distribution MagnitudelpsfJ RISA-3D Version 17.0.4 [C:\ ... \. .. \ ... \ ... \M2\2022\03 -March\SD0475\Risa3d\SD0475 Truss.r3d) Page 2 IIIRISA Company Designer Job Number Model Name M Squared Wireless Apr12,2022 11:17 PM Checked By: __ A NEMElSCHEK COMPANY 5D0475 Basic Load Cases (Continued) RI r. -X r.,,.v;tv y r.,avav z r.,avav I,_;nt ,. Pninl n: .... a ... , .... _ ....1 • ._. ~,·-'--11"> 4 Ice WP.iaht OL1 5 Wind + Ice Load AZI ... OL2 6 Wind + Ice Load AZI ... OL3 7 Service Live 1 LL 5 8 Seismic Load AZI 000 ELZ 9 Seismic Load AZI 090 ELX Load Combinations I 1 I Description D+L Envelope Joint Reactions .lnint X llbl I r. V llhl . ,.. 7 ru,1 It' UV II'•-'" It' MV llh.fll It' U'7 flb-fll I r. 1 N3 max -12562.603 1 3544.01 1 0 1 NC NC 0 1 0 1 2 min -12562.603 1 ':t'-4.4 01 1 0 1 N~ Nr. o 1 0 1 3 N13 max 12562.603 1 4617.039 1 0 1 NC NC 0 1 0 1 4 min 112!162.603 1 4617 O:lQ 1 o 1 Nr. NC o 1 0 1 5 Totals: max 0 1 8161 .048 1 0 1 6 min 0 1 81n1 n.11.a 1 0 1 Envelope Joint Displacements lnjnt X rinl I r. Y rinl I f' Z linl I r. X Rnt:itinn I "'-Y D"t"tinn I r. Z D,_+,.+inn I I f' 1 N1 max -.092 1 -.004 1 0 1 o 1 0 1 -5 622e-3 1 2 min -OQ? 1 -.004 1 0 1 o 1 o 1 _i:; i::??i:>-3 1 3 N2 max .11 1 -.013 1 0 1 0 1 0 1 6.198e-3 1 4 min .11 1 -013 1 o 1 0 1 0 '1 R.198e-3 1 5 N3 max 0 1 0 1 0 1 0 1 0 1 -6.947e-3 1 6 min 0 1 0 1 o 1 0 1 0 1 -6.947e-3 1 7 N4 max -.092 1 -.18:l 1 0 1 n 1 0 1 -!-i.648e-3 1 8 min -.092 1 -.1 R':l 1 o 1 o 1 0 1 _i:; &:.iH\e-3 1 9 N5 max .024 1 -.404 1 0 1 0 1 0 1 -5.076P.-3 1 10 min 024 1 -404 1 o 1 o 1 0 1 -!l 076e-3 1 11 N6 max -.058 1 -.561 1 0 1 0 1 0 1 -4.43e-3 1 12 min -058 1 -i:;i:::1 1 0 1 0 1 0 1 -4 43P.-3 1 13 N7 max .018 1 -.709 1 0 1 0 1 0 1 _3_39q.,._3 1 14 min 018 1 -70!=1 1 0 1 0 1 0 1 -3.399e-3 1 15 N8 max -.002 1 -.752 1 0 1 0 1 0 1 -6.549e-4 1 16 min -002 1 -7'-? 1 0 1 0 1 0 1 I_,:; 549e-4 1 17 N9 max -.003 1 -.758 1 o 1 0 1 0 1 2.448e-3 1 18 min -003 1 -7'-A 1 0 1 0 1 0 1 2 44p_.,._3 1 19 N10 max .066 1 -.621 1 0 1 0 1 0 1 4.356e-3 1 ?n min oi::i:: 1 __ i::?1 1 0 1 0 1 0 1 4_3i:;,:;.,._3 1 21 N11 max -.01 8 1 -.46 1 0 1 0 1 0 1 5.497e-3 1 22 min -.018 1 -.46 1 0 1 n 1 o 1 5.497e-3 1 23 N12 max .11 1 -.21 1 0 1 0 1 0 1 6.225e-3 1 RISA-3D Version 17.0.4 [C:\ ... \. .. \ ... \. .. \M2\2022\03 -March\SD0475\Risa3d\SD0475 Truss.r3d) Page 3 IIIRISA A NEMETSCHEK COMPANY Company Designer Job Number Model Name M Squared Wireless S00475 Apr12,2022 11:17 PM Checked By: __ RISA-3D Version 17.0.4 [C:\ ... \. .. \ ... \ ... \M2\2022\03 -March\SD0475\Risa3d\SD0475 Truss.r3d] Page4 M SQUAR(c.71 WIRELESS APPENDIX A Design Tables & Resources Page4 M SQUAR [•l , WIRELESS__,. Seismic Loads Latitude and longitude were determined from existing as-builts, AT&T records, and confirmed using GoogleEarth. Design spectral acceleration parameters were optained using NSHMP Hazard, a program by USGS for determining seismic values within the continental US. Input data and program output are provided at the end of this report. Latitude: 33.15806 ° Longitude: -117.3389 ° s = s 1.062 Site Class: D F = a 1.20 Occupancy Category: II SMs = 1.274 Importance Factor, I: 1.00 Sos= 0.850 Seismic Design Catagory D S1= 0.384 Amplification Factor, 1'>: 1.0 F = V 0.00 Response Factor, Rp: 2.5 SM1= 0.000 z = 1.0 ft So1 = 0.000 h = 1.0 ft Telecommunication cabinets and radio equipment are non-structural components to be designed under the provisions of ASCE 7-16 chapter 13. (ASCE 7-16 13.3-3) Fp.min = 0.3S vsl PWP = 0.255 W P (ASCE 7-16 13.3-1) F, = 0.4(f )W, (1 +21) = 0.408 W P VseFP = 0.408 WP (ASCE 7-16 13.3-2) F p,max = 1.6S os l PWP = J.359 WP NIEJll£Nj SOCIElY Of CM. ENIINEIRS Address: No Address at This Location Wind Results: Wind Speed 10-year MRI 25-year MRI 50-year MRI 100-year MRI Data Source: Date Accessed: ASCE 7 Hazards Report Standard: ASCE/SEI 7-16 Risk Category: II Soil Class: D -Default (see Section 11 .4.3) 96 Vmph 66 Vmph 72 Vmph 77 Vmph 82 Vmph Elevation: 81.21 ft(NAVD88) Latitude: 33.15806 Longitude: -117.33892 ASCE/SEI 7-16, Fig. 26.5-18 and Figs. CC.2-1-CC.2-4, and Section 26.5.2 Tue Apr 12 2022 Value provided is 3-second gust wind speeds at 33 ft above ground for Exposure C Category, based on linear interpolation between contours. Wind speeds are interpolated in accordance with the 7-16 Standard. Wind speeds correspond to approximately a 7% probability of exceedance in 50 years (annual exceedance probability= 0.00143, MRI= 700 years). Site is not in a hurricane-prone region as defined in ASCE/SEI 7-16 Section 26.2. https://asce7hazardtool.online/ Page 1 of 3 Tue Apr 12 2022 AMBIICAN SOCIETY Of CM. ENGINEB\S Seismic Site Soil Class: Results: Ss : S1 Fa : Fv : SMs SM1 D -Default (see Section 11.4.3) 1.061 So1 N/A 0.384 TL : 8 1.2 PGA : 0.467 N/A PGA M: 0.561 1.273 F PGA 1.2 N/A le 1 Sos 0.849 Cv : 1.312 Ground motion hazard analysis may be required. See ASCE/SEI 7-16 Section 11.4.8. Data Accessed: Tue Apr 12 2022 Date Source: usGs Seismic Design Maps https://asce 7hazardtool .onlinel Page 2 of 3 Tue Apr 12 2022 MelCAN SOCIETY <f 1M. ENGINIBIS The ASCE 7 Hazard Tool is provided for your convenience, for informational purposes only, and is provided "as is" and without warranties of any kind. The location data included herein has been obtained from information developed, produced, and maintained by third party providers; or has been extrapolated from maps incorporated in the ASCE 7 standard. While ASCE has made every effort to use data obtained from reliable sources or methodologies, ASCE does not make any representations or warranties as to the accuracy, completeness, reliability, currency, or quality of any data provided herein. Any third-party links provided by this Tool should not be construed as an endorsement, affiliation, relationship, or sponsorship of such third-party content by or from ASCE. ASCE does not intend, nor should anyone interpret, the results provided by this Tool to replace the sound judgment of a competent professional, having knowledge and experience in the appropriate field(s) of practice, nor to substitute for the standard of care required of such professionals in interpreting and applying the contents of this Tool or the ASCE 7 standard. In using this Tool, you expressly assume all risks associated with your use. Under no circumstances shall ASCE or its officers, directors, employees, members, affiliates, or agents be liable to you or any other person for any direct, indirect, special, incidental, or consequential damages arising from or related to your use of, or reliance on, the Tool or any information obtained therein. To the fullest extent permitted by law, you agree to release and hold harmless ASCE from any and all liability of any nature arising out of or resulting from any use of data provided by the ASCE 7 Hazard Tool. https://asce7hazardtool.online/ Page 3 of 3 Tue Apr 12 2022 Hazardous Materials Questionnaire County of San Diego, Department of Environmental Health and Quality PO Box 129261, San Diego, CA 92112-9261 (858) 505-6700 (800) 253-9933 www.sdcdehq.org Record ID#: DEH2005-HUPFP-204920 Plan Check#: DEH2022-HHMBP-011916 Balance Due: $412.00 Business Name Business Contact AT&T Wireless Telephone# Plan File# AT & T Wireless (858) 964-7 403 Project Address 1015 CHESTNUT AVE D3 City CARLSBAD State CA Zip Code 92008-2564 APN # 205-190-25-12 Applicant Christine Strileckis Applicant E-Mail cstrileckis@md7.com Applicant Telephone # (858) 964-7403 The following questions represent the facility's activities, NOT the specific project description. PART I: EIRE DEPARTMENT· HAZARDOUS METERIALS DIVISION: OCCUPANCY CLASStf lCATION:(Not required for projects within the City of San Diego.) Indicate by selecting the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are selected, Applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: B-2 Facility's Square Footage (including proposed project): 302.56 □ Explosive or Blasting Agents Organic Peroxides □ Water Reactives IBl Corrosives □ □ Compressed Gases Flammable/Combustible Liquids □ □ Oxidizers Pyrophorics □ Cryogenics □ Other Health Hazards □ □ Highly Toxic or Toxic Materials □ None of These □ Flammable Solids □ Unstable Reactives □ Radioactives PART U: SAN DIEGO COUNTY DEPARTMENT Of ENVIRONMENTAL HEAL TH • HAZARDOUS MATERIALS DIVISION (HMDW the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, in person at 5500 Overland Ave., Suite 110, San Diego, CA 92123, or by phone at(858) 505-6700 prior to issuance of a building permit. FEES ARE REQUIRED. Project Completion Date: 8/30/2022 €. o 1. Y~S ~ Is your business listed on the reverse side of this form? (check all that apply). T"":. r_ 'E-\ \/ 2. □ IBJ Will your business dispose of Hazardous Substances or Medical Waste in an-0~ IBl O Will your business store or handle Hazardous Substances in quantities equal'tr;,}greater than \ ~S'}'l.'1.. 3· 55 gallons, 500 pounds, or 200 cubic feet? \ \\_ \ '- 4. D D Will your business handle carcinogens or reproductive toxins in any quantity? JV S1c>p._D 5. □ IBI Will your business use an existing, or install an underground storage tank? "-p_ \_ ..,\ 6. □ IBI Will your business store or handle Regulated Substances (CalARP)? of Cr \S\ 0 \.,. 7. D IBI Will your business use or install a Hazardous Waste Tank System (Title 22, Artic:J& f11)'X ~ \ C Q \\} 8 0 IBI Will your business store petroleum in tanks or containers at your facility with a to~~/CVrfl~flliCif? · equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Stor~&tr, □ □ □ CalARP Exempt CalARP Required CalARP Complete Review Date: PART UI: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT IAPCDl: If the answer to Question #1 is 'Yes' and the answer to Question #2 is 'No', the applicant must contact the APCD prior to the issuance of a building or demolition permit. If any answer to Questions #3, #4, or #5 is 'Yes', the applicant must contact the APCD prior to the issuance of a building or demolition permit. If the answer to Question #3 or #4 is 'Yes', the applicant may need to submit an asbestos notification form to the APCD at least 10 working days prior to commencing demolition or renovation (some residential projects may be exempt from the notification requirements). Contact the APCD at 10124 Old Grove Road, San Diego, CA 92131 or telephone (858) 586-2600 for more information. 1. 2. 3. 4. YES NO □ Ii!! □ □ □ □ □ Ii!! Will any existing building materials be disturbed as part of this project? (If the answer is 'Yes', an asbestos survey may be required.) Has a survey been performed to determine the presence of asbestos containing materials? Will the project involve handling or disturbance of any asbestos containing materials? 5. □ □ Will the project involve the removal of any load supporting structural member? Will the subject facility or construction activities include operations or equipment that emit or are capable of emitting an air contaminant? (See the APCD factsheet at http://www.sdapcd.org/info/facts/permits.pdf 6. □ □ (ANSWER ONLY IF QUESTION 5 IS 'YES') Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)? Search the California School Directory at http://www.cde.ca.gov/re/sd/ for public and private schools or contact the appropriate school district. Briefly describe business activities: Unoccupied wireless facility. Briefly describe proposed project: Modification to an existing wireless facility. Current total of 39.52 electrolyte gallons. Addition of 19.76 gallons for a new total of 59.28. I declare under penalty of perjury that to the best of my knowledge and belief, the responses made herein are true and correct. I&!; Fees Acknowledged: I&! Christine Strileckis 6/28/2022 Name of Owner or Authorized Agent Date FOR OFFICIAL USE ONLY FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: BY: ----------------------------- DATE: __________ _ EXEMPT OR NO FURTHER INFORMATION RELEASED FOR BUILDING PERMIT BUT NOT FOR RELEASED FOR OCCUPANCY REQUIRED OCCUPANCY COUNTY-HMO• APCD COUNTY-HMO APCD COUNTY-HMO APCD ,:ffOt S;\j O ~,· II, (? REVIEWED ~'& M. Martinez SIGNATlIRE 7/8/2022 OATE 1-A.tn •A stamp in this box only exempts busines~"lS from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply. OEHQ_HMD_HMBP _Questionnaire v 2.0 (8/2021) Printed on: 7/8/2022@ 7:03 PM STORM WATER POLLUTION PREVENTION NOTES 1. All NECESSARY EQUIPMENT AND MATERIALS SHALL BE AVAILABLE ON SITE TO FAOLITATE RAPID INSTAI..LATION OF EROSION ANO SEDIMENT CONTROL BMPs VIHEN RAIN IS EMINENT. 2. THE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION OF THE CITY INSPECTOR AFTER EACH RUN-OFF PROOUONG RAINFALL J. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION CONTROL MEASURES AS MAY BE REQUIRED BY THE OTY INSPECTOR DUE TO INCOMPLETE GRADING OPERATIONS OR UNFORESEEN ORC\JMST ANCES VIHICH MAY ARISE. 4. ALL REMOVABLE PROTECTIVE DEVICES SHALL BE IN PLACE AT THE END OF EACH WORKING DAY VIHEN THE FlVE (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PECENT ( 40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL 5. ALL GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM AGGREGATE. 6. ADEQUATE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. 7. THE OTY INSPECTOR SHALL HAVE THE AUTHORITY TO ALTER THIS PLAN DURING OR BEFORE CONSTRUCTION AS NEEDED TO ENSURE COMPLIANCE WITH OTY STORM WATER QUALITY REGULATIONS. OWNER'S CERTIFICATE: I UNDERSTAND AND ACKNO'M..EDGE THAT I MUST: (1) llolPI.EMENT BEST MANAGEMENT PRACTICES (BMPS) OURING CONSlRUCTION ACTIVITIES TO 1HE MAXIIIIJM EXTENT PRACTICABLE TO AV!JO 1HE MOBIUZA TION Of" PCllUTANTS SUOi ~ SEDIMENT AND TO AVOID lHE EXPOSURE Of" STan.t WATER TO CONSlR\JCTION RELATED PCllUTANTS; AND (2) ADHERE TO, AND AT AU TIMES, COMPLY 'MTH THIS OTY APPRO',{I) TIER 1 CONSlR\JCTION SWPPP THROUGHOUT 1HE DURATION Of" 1HE CONSlR\JCTION ACTIVITIES UNTIL THE CONSlRUCTION WORK IS COMPl.£TE AND APPRO',{I) BY lHE OTY Of" CARI.SBAD. OWNER(S)/OWNER'S AGENT NAME (PRINT} OWNER(S)/OWNER'S 4GENT NAME (SIGNATURE) E-29 DATE • STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 CB ___ _ SW BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE Etosion Canlrol -Conlrol BMPs Tracking Non-StonnW* -Monogomer,tandM*ills BMPs CcnlrdBMPs ~-PoUon Conlrol BMPs j ] s -i ..., "' i fi ~ Ii u 1 ,§ .,. -~ j I .., " ]; .5 ~ Ii ::I ..., .. ~ .r .t ~ i . .,. H It -~ s jg .§ ; ~ -~ -;; Besl Management Practice' ~ .la .. '! f C' " ... I Ii i-: ~ ... ,!:: i fi,. 1 %i (BMP) Description ➔ •"' ·5 f.t i ~ .!! a, ·5 Ii .§: ..., .. :::, ::I .. i ~ j ~~ 6 0 ~ ~ ii g 6:;: "i~ l~ Ii Ii I t ii ~~ of ~ ~, -~ 1J i ~-la ~§-O:] j J ~o 8-! ! '8 gi ti !15 .., 0 llg 1,·5 ~ ] !~ il .,. <> i ! 1.§ ·-!i :l!i I!! ~ 0 ~ cnct en~ ~ .. _ :I iii ;ii::,, w6 !11 VI> 0.. >0 ::111"1 ::C::I CASO>, Desiglatlon ➔ ,.._ co "' -..., ♦ "' '° ,.._ co 0 N ..., ,.._ co ' N..., ♦ "' '° I I I ' I I I I I I I ' ' I ' I I I I I I I I fi3 ~ l.l l.l ti! ti! ti! ti! ti! ti! ti! ti! I!: I!: C/"I C/"I C/"I C/"I i i i i i i Conmdon AcMy z z z z Gradina/Soi Di1turbonce Trench inn lrxcawtion st-""ino l)rilino /Bomo Cona-ete/A•""alt Scm:uttino Cana-ete Flatwori< Pama Canduit/PiDe Installation Stucco /Mortar Wor1c Waste Di-al Staaina /Lav Down Area E-·'---t Maintenonce ond fuelina Hazardous Substance Use /Ster- Dewaterina Site Access Aa-oss Dirt other /list\: Instructions: 1. Check the box to the left of all applicable construction acti..,;ty (first column) expected to occur during construction. 2. Located along the top of the BMP Table i1 a list of BMP's with it's correspanding California Stonnwater ()iality Association (CASQA) ~lion number. Choose one or more BMPs you intend to use CMilg construction from the li1l Check the box where the chosen acti..,;ty row intenec:ts with the 8MP column. 3. Refer to the CASOA construction hon<l>ook for infonnation ond detols of the chosen BMPs ond how ta apply them to the project. SHOW THE LOCATIONS OF ALL CHOSEN BMPs ABOVE ON THE PROJECTS SITE PLAN/EROSION CONTROL PLAN. SEE THE REVERSE SIDE OF THIS SHEET FOR A SAMPLE EROSION CONTROL PLAN. -BMP's are subject to field Inspection- PROJECT INFORMATION Site Ad<hss: ____________ _ Assessor's Parcel Numb«: ________ _ Emergency Cantact: Nom«------------- 24 Hour Phone: _________ _ Canstruction Threat to Stonn Wot.-()iallty (Check Box) 0 MEDIUM O LOW % !:-•i ~, bo .§j co I i Page 1 of 1 REV 02/16 )()( 0 xx ~ ~ SCALE: \ -BMP's are subject to field Inspection- xx xx I EXZ$1N; SNU F'Nla..Y, -=::~ _,,.,.-= l'flOKJ5CD _, FToJlJJI -;=~, owrDRMI \~ f\(\, ',-, ." ,';,/~ -o•·~ I ~1:p \ 07 ~o , 7!'! LEGEND • DWG.NO. SYMBOL PROP£R1Y LJH( SILT FD/CE f18lJI ROU. PRfSERVAnON OF DOSnNC /Ill.ET PROTE:CnON ~\,fl ~ 8£RIJ/BARRIER OIRECT10N/COURSE OF FtOW SE-1 5£-5 EC-2 SE-10 5£-6 HYORAUUC t.lULCH,MwRosffl) EC-I. EC-• STABIUZED CONSTRUCTION fNT1W/CE 111-1 t.lATEJIIALS Of.l.MRY ANO STORAGE AREA WM-I TEllPORARY TRASH/SOUD WASTE: Wll-5 HAZARDOUS ANO CONCRfJf IIM-6, Wll-8 WASTE: IINIACEMENT SNI/TARY WASTE: 1111-9 (POffrABLE TO/l£T) N4S45"45"W -0-----0---- -x-x-x-x- 1272222221 ggB cx:::x:::x::x:: ~ m~IU I ltlH I I Wll-5 I I ::: I lwt.l-91 "SrANIWIO DRAWIIIGS (SE-5. Wll-5, ETC.) CAN BE FOUNO AT TU[ CAUFORNIA STORIIWAIVI OUAllTY ASSCCIAT10N {CASGII) WEBSITE:: h/lp:/ ;,,.,,.,.cobmphandbool<s.com/ ~ B_UANTITY ENCINA WASTEWATER AUTHORITY INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY 6200 Avenida Encinas, Carlsbad, CA 92011 Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater discharge permitting under normal operating conditions. They are exempt because (a) they discharge no process wastewater (i.e., they only discharge sanitary wastewater with no pollutants exceeding any local limits ), and (b) they have no potential to negatively impact the EWPCF or other wastewater treatment plants in the ESS. Any questions regarding exemptions should be referred to EWA Source Control staff. □ Automobile Detailer s □ Barber/Beauty Shops □ Business/Sales Offices □ Cleaning Services □ Carpet/Upholstery □ Childcare Facilities □ Churches □ Community Centers □ Consulting Services □ Contractors □ Counseling Services □ Educational Services (no auto repair/film □ Financial Institutions/Services □ Fitness Centers □ Gas Stations (no car wash/auto repair) □ Grocery Stores (no film developing) □ Residential based Businesses developing) □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Hotels/ Motels (no laundry) Laundromats Libraries Medical Offices (no x-ray developing) Mortuaries Museums Nail Salons Nursing Homes Office Buildings (no process flow) Optical Services Pest Control Services (no pesticide repackaging for sale) Pet Boarding/Grooming Facilities Postal Services (no car wash/auto repair) Public Storage Facilities Restaurants/Bars Retail/Wholesale Stores (no auto repair/film developing) Theaters (Movie/Live) CERTIFICATION STATEMENT I cerf(/j! that the information above is true and correct to the best of my knowledge. Digitally signed by Christir.e Strlleck,s 1 , , 1:,; I/ Date: 2022.04.1911·22'04 Signature: __ , __ -_· ;r_-_:_1_,;__ _'_.:·':.:''::'·------ Christine Strileckis Facility Contact: __________ _ Christine Strileckis Print Name: ____________ _ Title Land Use I ENCINA WASTEWATER AUTHORITY 04/19/2022 Date: ____ _ 6200AVENIDA ENCINAS, CARLSBAD, CA Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com Page 2 of 2 SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFiCE USE ONLY RECORD ID# _________________ _ PLAN CHECK# ________________ _ BP DATE Business Name" AT&T Wireless Business Contact Telephone# Project Address (include suite) City San Diego Mailing Address (include suite) City San Diego Project Contact Applicant E-mail State CA State CA Zip Code Zip Code Telephone# APN# Plan File# The following questions represent the facility's activities, NOT the specific project description. PART I: FIRE DEPARTMENT-HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San Diego): Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled, applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: Facility's Square Footage (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These. 4. Flammable Solids 8. Unstable Reactives 12. Radioactives PART 11: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEAL TH -HAZARDOUS MATERIALS DIVISION (HMO): If the answer lo any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 170, San Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. □ CalARP Exempt I FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: 1. 2. 3. 4. 5. 6. 7. 8. YES NO (for new construction or remodeling projects) Is your business listed on the reverse side of this form? (check all that apply). □ □ □ □ Will your business dispose of Hazardous Substances or Medical Waste in any amount? □ □ Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? B B □ ~ , Will your business store or handle carcinogens/reproductive toxins in any quantity? Will your business use an existing or install an underground storage tank? Will your business store or handle Regulated Substances (CalARP)? □ Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? ti Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). Date Initials □ CalARP Required I Date Initials □ CalARP Complete 04/1912022 / Date Initials PART 111: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): The following questions are intended to identify the majority of air pollution issues at the planning stage. Your project may require additional measures not identified by these questions. Some residential projects may be exempt from APCD requirements. If yes is answered for either questions 1, 2 or 5 or for more comprehensive requirements, please contact APCD at apcdcomp@sdcounty.ca.gov; (858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131. 1. 2. 3. 4. 5. 6. YES NO B □.-' □ □ □ □ □ □ □ □ Will the project disturb 100 square feet or more of existing building materials? Will any load supporting structural members be removed? (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by an individual that has passed an EPA-approved building inspector course? (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Based on the survey results, will the project disturb any asbestos containing material? If yes, a notification may be required at least 10 working days prior to commencing asbestos removal. Additionally, a notification may be required prior to the removal of a load supporting structural member(s) regardless of the presence of asbestos. Will the project or associated construction equipment emit air contaminants? See the reverse side of this form for typical equipment requiring an APCD permit. If yes, contact APCD prior to the issuance of a building permit. (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school bounda Briefly describe business activities: Briefly describe proposed project: I declare under penalty of pe~ury that to the best of my knowledge and belief t e responses made herein are true and correct. I I Name of Owner or Authorized Agent Signature of Owner or Authorized Agent Date FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ________________________________ _ BY· DATE· I I EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR.OCCUPANCY COUNTY-HMO* APCD COUNTY-HMO APCD COUNTY-HMO APCD *A stamp in this box only exempts businesses from completing or updating a Hazardous Matenals Business Plan. Other permitting requrrements may still apply HM-9171 (9/18) County of San Diego -DEH -Hazardous Materials Division { City of Carlsbad DETERMINATION OF PROJECT'S SWPPP TIER LEVEL AND CONSTRUCTION THREAT LEVEL E-32 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov I'm applying for: □ Grading Permit Project Name: AU SG NR Radjo CBand Address: 1015 Chestnut Avenue ij Building Permit Project ID: spp475 APN 205-190-25-12 □ Right-of-way permit □ Other DWG #/CB# _____ _ Disturbed Area: -"'N,..fA,_ _ __,Ac Section 1: Determination of Project's SWPPP Tier Level SWPPP {Check annlicable criteria and circle the corresoondina SWPPP Tier Level, then ao to section 21 Tier Level ExemQt -No Threat Project Assessment Criteria My project is in a category of permit types exempt from City Construction SWPPP requirements. Provided no significant grading proposed, pursuant to Table1, section 3.2.2 of Storm Water Standards, the followina □ermits are exem□t from SW PPP reauirements: Exempt ► Electrical ► Patio ► Mobile Home ► Plumbing ► Spa (Factory-Made) ► Fire Sprinkler ► Mechanical ► Re-Roofing ► Sign ► Roof-Mounted Solar Array .. . ..... .... Tier 3-Significant Threat Assessment Criteria -(See Construction General Permit (CGP) Section I.B)* □ My project includes construction or demolition activity that results in a land disturbance of equal to or greater than one acre including but not limited to clearing, grading, grubbing or excavation; or, □ My project includes construction activity that results in land disturbance of less than one acre but the construction activity is part of a larger common plan of development or the sale of one or more acres of disturbed land surface or, □ My Project is associated with construction activity related to residential, commercial, or industrial Tier3 development on lands currently used for agriculture; or □ My project is associated with construction activity associated with Linear Underground/overhead Projects (LUP) including but not limited to those activities necessary for installation of underground and overhead linear facilities (e.g. conduits, substructures, pipelines, towers, poles, cables, wire, towers, poles, cables, wires, connectors, switching, regulating and transforming equipment and associated ancillary facilities) and include but not limited to underground utility mark out, potholing, concrete and asphalt cutting and removal, trenching, excavation, boring and drilling, access road, tower footings/foundation, pavement repair or replacement, stockpile/borrow locations. □ Other per CGP Tier 2-Moderate Threat Assessment Criteria: My project does not meet any of the Significant Threat Assessment Criteria described above and meets one or more of the following criteria: □ Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, □ Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of the additional following criteria: Tier2 • located within 200 feet of an environmentally sensitive area or the Pacific Ocean; and/or, • disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical; and/or • disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse; and/or • construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 throuqh Apr. 30). Tier 1-Low Threat Assessment Criteria □ My project does not meet any of the Significant or Moderate Threat criteria above, is not an exempt permit type per above and the project meets one or more of the following criteria: Tier 1 • results in some soil disturbance; and/or • includes outdoor construction activities (such as roof framing, saw cutting, equipment washing, material stock□ilina, vehicle fuelina, waste stock□ilinn\ * Items listed are excerpt from CGP. CGP governs cntena for triggers for Tier 3 SWPPP. Developer/owner shall confirm coverage under the current CGP and any amendments, revisions and reissuance thereof. E-32 Page 1 of 2 Rev. 2/16/16 SWPPP Section 2: Determination of Project's Construction Threat Level Tier (Check applicable criteria under the Tier Level as determined in section 1, circle Construction Level the corresponding Construction Threat Level, then complete the Threat Level sianature block below! Exempt -Not Applicable -Exempt Tier 3 -High Construction Threat Assessment Criteria: My Project meets one or more of the following: □ Project site is 50 acres or more and grading will occur during the rainy season □ Project site is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA High □ Soil at site is moderately to highly erosive (defined as having a predominance of soils Tier3 with USDA-NRCS Erosion factors kf greater than or equal to 0.4) □ Site slope is 5 to 1 or steeper □ Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 -April 30). □ Owner/contractor received a Storm Water Notice of Violation within past two years Tier3 Medium Construction Threat Assessment Criteria Medium ~ All projects not meeting Tier 3 High Construction Threat Assessment Criteria Tier 2 -High Construction Threat Assessment Criteria: My Project meets one or more of the following: □ Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA □ Soil at site is moderately to highly erosive (defined as having a predominance of soils High with USDA-NRCS Erosion factors kt greater than or equal to 0.4) Tier2 □ Site slope is 5 to 1 or steeper □ Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1-Apr. 30). □ Owner/contractor received a Storm Water Notice of Violation within past two years □ Site results in 10,000 sq. ft. or more of soil disturbance Tier 2 -Medium Construction Threat Assessment Criteria Medium ~ My project does not meet Tier 2 High Threat Assessment Criteria listed above Tier 1 -Medium Construction Threat Assessment Criteria: My Project meets one or more of the following: □ Owner/contractor received a Storm Water Notice of Violation within past two years Medium □ Site results in 500 sq. ft. or more of soil disturbance Tier 1 □ Construction will be initiated during the rainy season or will extend into the rainy season (Oct.1-April 30) Tier 1 -Low Construction Threat Assessment Criteria Low lii:I My project does not meet Tier 1 Medium Threat Assessment Criteria listed above I certify to the best of my knowledge that the above statements are true and correct. I will prepare and submit an appropriate tier level SWPPP as determined above prepared in accordance with the City SWPPP Manual. I understand and acknowledge that I must adhere to and comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standards at all times during construction activities for the permit type(s) checked above. The City Engineer/Building Official may authorize minor variances from the Construction Threat Assessment Criteria in special circumstances where it can be shown that a lesser or higher SWPPP Tier Level is warranted. Owner/Owner's Authorized Agent Name: Title: City Concurrence: Yes No Christine Strileckis Land Use I {For City Use Only) Owner/Owner's Authorized Agent Signature: Date: By: I O,gltall)I ,,gM<J b)'Cho11ton< 04/19/2022 j.,:.;r r-4 ltnle,k,1 □•to 101104 1911 ll 28-01"()() Date: Project ID: E-32 Page 2 of 2 Rev. 2/16/16