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Home My WebLink About1905 CALLE BARCELONA; 126; CBC2022-0304; Recycle{city of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 ft\3 7 2li'/3 [)_evel9J)rn_e_11_t Ser_vices Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov APPLICABLE TO NEW CONSTRUCTION, ALL RESIDENTIAL ADDITIONS AND ALTERATIONS AND COMMERCIAL ADDITIONS AND ALTERATIONS OVER $200K. If you have questions about the recycling requirement or completing this form, please contact Republic Services at (760) 332-6464 a certified C&D recycler, or the Carlsbad Building Division at (442) 339-2700. Please note: Unless you are self-hauling, Republic Services or approved haulers must be used for all construction projects within the City of Carlsbad. PART 1 Complete and submit this form when apph,1ing for a Building Permit. Note: Permits will not be issued without a completed Construction Waste Management Plan. Applicant Information Permit No. C8C )._b .l.:l_ O;, O '-f Project Title Nike by /,4 Cos-f,q Project Address /905 CA/i,;:_ b4!' "-"-l 6 YI d APN Ouciky Owner cr;;,t~ Architect Other Applicant Name /ti,c64e/ □ □ □ Last First ApplicantAddress ;}__,!;DO brc/,~"d LtH ( Ex.c..a./s. ioj'___ ma Phone _L __ _L_ _________ E-mail Address Applicant Mailing Address (if different than project address) Project Type Residential (00 Public Building (check all that apply): □ □ Brief Description !t}Te.~ /Ort Tl I;.,, I IV\ I() 6 f\.._, fVlE f L-VD tLk I Industrial □ >-,._ -0 Project Size __ 7,...,,0"'-"·-"'Q'---_______ Estimated Cost of Project$ _________________ _ (square footage) Please check the appropriate box: I plan on using REPUBLIC SERVICES roll-off bin(s) for all materials and will provide all receipts after construction. I plan on using a City Approved Hauler and will provide all receipts after construction. This is a proposed LEED certified project and I plan on separating materials on site in conjunction with Republic 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 (b l (__ h. I\ .e I Dud fi f Signature Page 1 of 3 Rev. 05122 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: Permit No. C {?C ;)._ 6d-_:}.._ -CJ 3#-ojectTitle ProjectAddress /'10'J Lil//~ /3.IJ/2.C<e/ 6(\ If S[F Applicant Name D(.(d /c!f rn, c.. h lit/ /J..G APN Phone (q_(z) -Z -G I c23 Last First 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. Goal: the diversion rate shall be 65% by weights of debris. A B C Material Type Estimated Place a (0) check Place a (0) check next Place a (0) check next Waste Quantity next to ltems to be to items to be to items to be (tons) reused or salvaged recycled disposed at landfill Complete this line of the table only if only using WASTE MANAGEMENT roll-off bins. Mixed C&D Debris □ □ □ / Asphalt & Concrete • !) □ □ □ Brick/ Masonry/ Tile ' .J.. -5" □ □ □ Mixed Inert Debris 'J-.S □ □ □ Cabinets, Doors, Fixtures, .. - Windows (circle all that apply) ,j □ □ □ Carpet 'J.S □ □ □ Carpet Padding/ Foam 0 □ Cardboard S' □ □ □ Ceiling Tile (acoustic) ;]_S □ □ □ Drywall (used, new, scrap) ' :)__i) □ □ Landscape Debris (brush, trees, □ stumps, etc.) No dirt. □ □ Unpainted Wood & Pallets I :) □ □ □ Roofing Materials (j □ □ □ Scrap Metal ' ;) .s-□ □ □ Stucco □ Other: □ □ □ TOTAL = ;,_; To meet 65% Diversion Requirement (estimate) _3:=:....:...' S""-___ x 0.65 ----'d."""--' --"J-:_c__,_]-=.3-~ ____ tons Total Estimated Waste from above Minimum Required Diversion Contractor/Owner Signature hJ Ch 11e/ Q~rj/' Date a d: Page 2 of 4 Rev. 05122 Conversion Table for Common Construction Waste This document is informational onlv. It is here to helo vou convert truckload quantities to tons if necessary. 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 Sh!ngles, 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 C cy X estimate = cy X estimate = Total all = Page 3 of 3 Rev_ .05122 ti1111! nispectHJn, obtain City Approved hauler receipts and return prior to final DEBRIS RECYCLING REPORT (ACTUAL): 1 SECTION A 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._Cl3_~20~0304 Print Name Michael Dudley -----------· Address 1905 Calle Barcelona Date 5/12/23 ---. ----------------------------- SECTION B 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 Material Type A B C Actual Amt Actual Amt Actual Amt Reused or Recycled Disposed in Salvaged Landfill Destination Facility (Name, Address, Phone) E_JC_pmp_k;_ 01/01/2020 Concrete (broken) 5 tons Palomar Transfer Station, 5960 El Camino Real -3/15/23] -/760) 603-015_3 ____ _ Palomar Transfer Station, 5690 El Camino Real Mixed C&D 160-603-01s3 3.59 0 0 3131123_ I _ -------,--1-------t-----+---------+~pi-'ai=lo~m~a,°'T'"ra=n~sf'e~, s~,.~,~,o~n.~5~69~0~E"I ~Camino Real Mixed C&D 160-603-0153 2.93 0 0 4/21/23 ------------+-------+-----+--------+-c-Pa"'"10-m~a~,~T,-an~,=1e-r=s,-a,-,o-n~, s·690 EICamfnO Reil Mixed C&D 160-603-0153 0 0 2.66 --------------------i-- 4/28/2_3 1---_11,1ixed C&D __ --+------l-'P-"'al""ombWardTllra"'nLsf_e,_s_,._"_on_._5_69_0_,1 ca_m_ino_R•-•I_ 5/9/23 + __ Mixed C&_D ___ +-------1-----+--------l--'JPa"-loctmrua"'r"'Tr'-'a'-'ns_f•_r_s,_a_tio_n_, 5_6_9_0-EI Camino Real 1.45 0 0 0 0 1.22 ' -, --·- -t -------- 1 --··----t--- @TOTAL SECTION C Diversion Rate Achieved 7.97 ----__J 11.85 _____ ~~ 67 % Total of columns A+ B Total of columns A+ B + C DIVERSION Contractor/Owner Signature Michael D_ud_l_e~y __ _ Date 5/16/23 ---' Attach the following documentation to this Report: Return completed form and documentation to: Original recycling weight tickets, landfill weight tickets Original donation receipts with photos and/or itemized descriptions Any other relevant information to support Recycling Report City of Carlsbad Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 Page 3 of 4 Rev. 04/22 PJ\l,OMAR TR.Af;SFE:R 5960 £'. CAMINO RE.~L CARLSBAD, CA 92fc08 ''" "> ,., 1. t :S 4 t1e:K.11tt. • ~ ~c<-t4;:,,, Wlil! i p.tms l!!~e.1.fr r i,;, et r. a 1 ". . t'n; '~l'.'t::h 31, 2<:il l -REPOBI.IC SERVICES CAMINO .REAL -CITY OF CAN.: Ou't '!'.arch lL 202. l 3401 , CA 92008 nr:.ract :. ·INOOS1'~IAL YR 200 GROS$! 4 L 6()0 ,!TARI · , 140 ,.,_, .,y ,, ,,· • .. PIJ." , 1160 ," ·, :') . i./,\: . :·1:;:'. >i'< < TX:ac::tl;:t.~g '.Ot;y. 0 · >'.. <;1' 'i \' _'i«• I ~ijy . a.'''" ~ :, :;i gin: ~srrr 1ption 111 c,o CARLSBAD Scale rn Tare.,~~ Vehi <il ll 100, 'Mr;r 1'<!lt,; I; ; • f} llffl. , i;, ~6 am l\•C BOX PAl,OAA.R TRA.'¼ S F!i:P. 5960 E: CAMINO \U'.:.'IL CARLSBAJ::, CA '-2006 r> ~-(l":tJ -REPUBI.IC SERVICES CAMINO REAL CA 92C:09 1::A Ti.ck.:?t t·. •it,\, Wllli,Sllh:Q1tter:, r 1 ""' rr.o. -C!T't OF CAkt.i tt1', iw.i:ch n. 20::n O.!it: to.arch :n. 202l Vebi~l~, > 340 t lire f: cntra.'.::f.Z. INOCSTRIAL YR 200 B()L: c;ROS$ 41.600 TJ!lRE .· 0. , 140 J/lST , 860 't~•cli ng ot y: ,\:}' :':i ~I\; 1/ •. •.. ; 93 in: un oese.r TN C&D CARLSBAD scale In T.are ~t LOOI l~~Nl) I~Cl.'.tct lta te f.x tension 6; .,, illll '' 4(1 R~C SO'it Ta,;