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1304 BASSWOOD AVE; ; CBR2022-2399; Recycle
C Cityot Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 t£3 £ 20ZZ -Q..39 9 Development Services Building Division . 1635 Faraday Avenue 760-602-2719 www.carlsbadca.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 M anagement 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. Permit No. ·'")o 1.. "1.. -J-S '" Project Title _tl.=..:-,_0_\_o_~ __ c)el--__,_--'-''--=----------- Project Address \J,1c,~ ·1::..s~v_,.,J._ f\.vc (,/Ws ~J-. CJ\-~),.,o·~ APN Applicant Name )v'§.f A?)l> ) lA-\. ~""'-1 !::\::( ~ r2r l5Ct □ Last First Applicant Address C'~\r\1-_ CA--1~1 !> Phone ,l&t>) ~2s4 -}.l,l;b E-mailAddress ye(\,v\·,.\-..seo<v-w~\j .(~"\ ApplicantMailing Address Pb?> \/vu-" ~} U(eo-ff\J,k o4-q_~o\S'l-1 (if different than project address) Project Type {check all that apply): Residential [gJ Brief Description ? 1"-')h- Commercial □ ~-l\>':-7 AD u Public Building □ Industrial □ Project Size_q'_~_(=, _________ Estimated Cost of Project $_·3_-b_v_' K''--------------- (square footage) Please check the appropriate b_ox: O. ·-.· Q () O\.}'<.::)UC ~\J·\(JJJ "Q" I plan on using~Mfl.--N-A:6EM1:N·T roll-off bin(s) for all materials and will provide all receipts after construction. D I plan on self-hauling to a certified recycling facility and will provide all receipts aft er construction. D This is a proposed LEED certified project and I plan on separating materials on site in conjunction w ith 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 .M J~ .M () ~ I'(__ s;gnatu~~ Date Pagel of3 Rev. 2.10.21 PART 2 Complete before final inspection, obtain City Approved hauler receipts and return prior to final building approval. DEBRIS RECYCLI NG 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 demolit ion debris generated only from the project list ed 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. CBR2022-2399 Print Name Daniell e Boulila Address 1306 Basswood Ave. Date 04/07/2023 l,.•Or,..,•:• 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 w here mat erial is taken. Additional Project Log pages are available if necessary. Use City Conversion Table to convert volume t o 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 Examg.fe: Palomar Transfer Station, 5960 El 01/01/2020 Concrete (broken) 5 tons Camino Real -1760) 603-01 53 1/19/23 Mixed C&D Debris .91 tons Escondido Resource Recovery 10?1 W ~A;<-<-inn AvP /760) 745-1?0'.'l 2/11 /23 Mixed C&D Debris 3.17 tons Escondido Resource Recovery 1n'J1 -~Aissio□-All.a.(l.6.Q)..lA.~203_ 3/14/23 Mixed C&D Debris 1.66 tons Palomar Transfer, 5960 El Camino Real 1760\ 603-0153 4/06/23 Mixed C&D Debris .86 tons Palomar Transfer, 5960 El Camino Real 1760\ 603-0153 ©TOTAL 0 0 6.6 tons -.,:ran, ~ 65% Diversion Rate Achieved 0 6/.6 =o % 5 65%[l] Tot~ma, 'U,)'°' of coJ,me>A • B • C DIVERSION Contractor/Owner Signature ~ .A ./'""\. Date 04/07/2023 - Attach the following document~to this Re:Ort: -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. 04122 Escondido Resource Recovery l021 W Mission Ave Escondido, CA 92025 (760) 745-3203 Customer: 0000 Ticket : Date : LIGHTWEIGHT DEBRIS REMOV Commodity Units 11 SELFHAUL REFUSE .91 [Gross ( In) : 2l, 000 . lbs Scl#2 MANNY Escondido Resource Recovery 1021 W Mission Ave Escondido , CA 92025 (760) 745-3203 Custome r: 0000 Ticket: Date: LIGHTWEI Glj:'f DEjRI,S REMOV ... : Commodity Units 1 1 SELFHAUL REFUSE 3 .1 7 48ll In: 10:32 01/19/23 Out: 10 :32 Rate 98.00 per TON Tare 19,180 . lbs Scl#2 INVOICE Truck: 7294 Container: Route: 03011 Origin: 030 COUNTY Un Extended Charge 89 .18 Net: l,820. lbs] PAID CREDIT CARD 89.18 Driver INVOICE 16594 ;r:n: 13:57 Truck: 7294 02/11/?.➔ Q.p.t: 13;~7 . s;;ont;.ainer : Route: 08611 Origin: 086 Carlsbad -' Extended Rate Charge 98 .00 per TON 310.66 [Gross (I n): 25,520. lbs Man Wt Tare 19,180. lbs Stored Ne t: 6,340. lbs] PAID CREDIT CARD 310 .66 .,-~F\~~A ·'\ ,· ... . . . ~ ... . . Driver PALOMAR 'i'RANSFER 5960 EL CAMI NO REAL CARLSBAD, CA 92008 (760)603-0 153 000999 -CASH AND CHECK CUSTOMER ADDRESS Carlsbad, CA 92008 Contract : RESIDENTIAL-Yr. 2 GROSS 21 ,400 TARE 18 ,080 NET Tracking Qty: 3 ,320 0 .00 Qty 1. 66 Un it Descripti on TN MSW Origin: BARONA Signature : Scal e I n Tar e Out 100% '>J Ticket #: 2523325 In: March 14 , 2023 Out: March 1 4, 2023 Vehicl e : Al04498 Ref : BOL : IN BOUND CASH Rate Extension Tax $0 .00 $87.54 $1 45 .32 Total Paid Change .EDIT CARD-SCALE 3 :05 pm 3 :05 pm Total $145 .32 $145 . 32 $145 .32 $0.00 V PALOMAR TRANSFER 5960 EL CAMI NO REAL CARLSBAD, CA 92008 sw14-p l.ldv 014+1~/»), ~olJW~ ::,.-1 Ti cket #: 2532193 (760)603-0153 000999 -CASH AND CHECK CUSTOMER ADDRESS carlsbad, CA 92008 Contract: RESIDENTIAL-Yr . 2 GROSS 19,800 Scale In TARE 18,080 Tare Out NET 1,720 Tracking Qty : 0.00 Qty 0 .86 Unit Description TN MSW Origin : CARLSBAD Signature: 100% Weighmaster: aceveos I n : April 06, 2023 Ou t : April 06 , 2023 Vehicle : A104498 Ref : BOL: INBOUND CASH Ra te Extension $87 .54 $75 .28 Tax $0 .00 Total Paid Change .EDIT CARD-SCALE 1 :31 pm 1 :31 pm Tota l $75 .28 $75 .28 $75 .28 $0 .00 V