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Home My WebLink About2540 EL CAMINO REAL; A; CBC2022-0172; PermitBuilding Permit Finaled (city of Carlsbad Commercial Permit Print Date: 11/06/2023 Job Address: 2540 EL CAMINO REAL, # A, CARLSBAD, CA 92008-1286 Permit No: Status: CBC2022-0172 Closed -Finaled Permit Type: BLDG-Commercial Work Class: Tenant Improvement Parcel#: 1670305000 Track#: Valuation: $191,481.40 Lot#: Occupancy Group: B RESTAURANT #of Dwelling Units: Project#: Plan#: Bedrooms: Bathrooms: Construction Type:VB Orig. Plan Check #: Occupant Load: Code Edition: Sprinkled: Project Title: Description: 39 Plan Check#: 2019 No MOOYAH BURGERS AND FRIES: RESTAURANT Tl (1,445 SF} Property Owner: CARLSBAD PLAZA LIMITED GEOFF REESLUND PO BOX 8700 NEWPORT BEACH, CA 92658-8700 (949} 759-9531 x24 FEE BUILDING PLAN CHECK BUILDING PLAN REVIEW-MINOR PROJECTS (LOE) BUILDING PLAN REVIEW-MINOR PROJECTS (PLN) CERTIFICATE OF OCCUPANCY COMM/IND Tl-STRUCTURAL FIRE Plan Review (per hr -Regular Office Hours) 5B1473 -GREEN BUILDING STATE STANDARDS FEE STRONG MOTION -COMMERCIAL (SMIP) Total Fees: $2,310.51 Total Payments To Date: $2,310.51 Applied: 05/24/2022 Issued: 09/29/2022 Fina led Close Out: 11/06/2023 Final Inspection: 02/21/2023 INSPECTOR: de Roggenbuke, Dirk Alvarado, Tony Dreibelbis, Peter Salcedo, Felix Kersch, Tim Contractor: WNM ENTERPRISE INC 34011 SILVER LANTERN ST DANA POINT, CA 92629-2660 (951) 751-8846 Balance Due: AMOUNT $588.90 $194.00 $98.00 $15.00 $906.00 $447.00 $8.00 $53.61 $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 "fees/exaction." 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 I 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov Cicyof Carlsbad 2S-'fo Tenant Name#: Mooyah Burgers and Fries Vear Built: __ _ Occupancy:_B_2 __ COMMERCIAL BUILDING PERMIT APPLICATION 8-2 Plan Check Ca::!2o2Z-ot, a.._, Est. Value f I 'I'. '{ 'I/. o/0 PC Deposit&fd""SS .CJO Date :S--Z.. 61 .-.2,D2Z.. APN: __________ _ Lot #: ____ Year Built: _________ _ Construction Type:'f/B Fire sprinklers0YES(:}NO A/c:()YESQNO BRIEF DESCRIPTION OF WORK: T.I. for a new fast food restaurant within an existing shops bldg, new kitchen equip, new walls and finishes with new Mech, Elect & Plumb D Addition/New: ____________ New SF and Use, __________ New SF and Use ______ SF Deck, SF Patio Cover, SF Other (Specify) ___ _ [K]Tenant Improvement: +/. 1,445 SF, Existing Use: Fast Food Proposed Use: Fast Food _____ SF, Existing Use: _______ Proposed Use: ______ _ D Other: ------------------------------------ PRIMARY APPLICANT PROPERTY OWNER Name: Green Madness, LLC -Contact: Ash El Address: 16769 Bernardo Center Dr. City: San Diego State: CA Zip: 92128 Phone: 858-524-4141 Email: ?gfiee.11119e5t'J L~ E/ J 0 p r'f' e11 m q 'rlt' f]'_f ., tci1rJ DESIGN PROFESSIONAL Name: Charles Good-Man Address: 120 S. Kroeger City: Anaheim State:_C_A __ Zip: 92805 Phone: 949-422-7630 Name: Hughes Investments -Contact: Geoff Reeslund. AIA Address: 23 Corporate Plaza, STE 245 City: 23 Corporate Plaza Phone: 949-759-9531 Email: grees!und@hugesinv.com State: CA Zip:._9_26_6_0 __ _ usiness Name: \J--7 I\~ J \ ~ Ad re . l\ City: ba1:,c. ;Do ,v.± State: C A Zip: y 26 2 Phone: L:z J ( .._ ) r' /-88":f C. Email: cgoodman@PCD-Arch.com Email: b > l\.. ti> Lt--,"'--.._,__ j 0p. CC> "--'- Architect State License: _c_-_24_6_6_8 ________ CSLB License#\ "j qc:;. \ 'i' ::( Class: ___ ...,.....,.....,........,. Carlsbad Business License# (Required): nL(JSO lfi&&-(1.r, :;;oi.:-2_ APPLICANT CERTIFICATION: 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. /agree to comply with all City ordinances and State laws relating to building construction. \-u \ \\ '""' ii'N>.v-; Jc.~ ~ .. . ~ 8 -?2- NAME (PRINT):-Cb.arles Goad-Man ArQ~itect SIGN: CharlesGood-Man5.·,:::-·~'f-,·, DATE:--------- 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 REV. 04/22 THIS PAGE REQUIRED AT PERMIT ISSUANCE PLAN CHECK NUMBER: ______ _ ,A BUILDING PERMIT CAN BE ISSUED TO EITHER A STATE LICENSED CONTRACTOR OR A PROPERTY OWNER. IF THE PERSON SIGNING THIS FORM IS AN AGENT FOR EITHER ENTITY AN AUTHORIZATION FORM OR LETTER IS REQUIRED PRIOR TO PERMIT ISSUANCE. (OPTION A}: LICENSED CONTRACTOR DECLARATION: I herebyaffirmunderpenaltyof perjury that I am licensed under provisions of Chapter9 (commencing with Section 70DO)of Division 3 of the Business and Professions Code, and my license is inf ufl force and effect. I also affirm under penalty of perjury one of the following declarations (CHOOSE ONE): D1 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. PolicyNo. ___________________________________________ _ -OR- DI 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' com ensation insurance carrier and policy number are: Insurance Company Name: _______________________ _ Policy No. 5 \ <. l q fr; 6 Expiration Date: / 0 -I • 'Z C> 2 3 ~icate of Exemption: I certify that in the performance of the work for which this permit Is issued, t 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 ~ed (Sec. 3097 (i) Civil Code). Lender's Name: OJ[J(\ ~ Le11der's Address; ____ c.,_~-~-------------- CONTRACTOR CERTJFICAT/ON; The applicant certifies that aJJ documents and plans clearly and acwrately show alt existing and prcj,osed buildings, structures, access roads, and utilities/utility easements. All proposed modifications and/or additions ore clearly labeled an the site pion. Any potentially existing detail within thef e plans inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the su itted documents and plans show the correct dimensions of the property, buildings, structures and their setbacks from property tines and from one another; access roads/easements, and utiliti . The existing and proposed use of each building as stated ,s true and correct; aJJ easements and other encumbrancejto evelopment have been accurately shown and labeled as well as all on-srt gradmg/s1te preparation. Alt improvements existing an the property were completed m accordance with all regu/at1 ns m existence at !he !1me of their struawn. unless otherw,se noted NAME (PRINT): l,L.i ""'-fY\a.,N C SIGNATURE:~=~c..:_::-~_-_::_::~ __ DATE: <-j-2q--2L Note: If the person signing above is an authorized agent for the contractor provide a letter of authorization on contractor letterhead. (OPTION B): OWNER-BUILDER DECLARATION: I hereby affjrm that I am exempt from Contractor's License Law for the following reason: D I, 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). -OR- 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). -OR- DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: AND, D FORM B-61 "Owner Builder Acknowledgement and Verification Form" is required for any permit issued to a property owner. 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.lunderstandthatacopyoftheapplicab/elaw,Section7044ofthe8usinessandProfessionsCode,isavoilableuponrequestwhenthisapplicationis submitted or at the following Website: http:l lwww.leginfo.ca.gov/calaw.html. OWNER CERT/FICA TION; The applicant certifies thot oil documents and plans dearly ond accurately show o/1 existing and proposed buildings, structures, access roads, and utilities/utility easements. All proposed modifications and/or additions ore clearly labeled on the site pion. Any potentially existing detail within these plans inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show the correct dimensions of; the property, buildings, structures and their setbacks from property lines and from one another; access roods/easements, ond utilities. The existing and prop0$ed use of each building as stated is true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site grading/site preparation. All improvements existing on the property were completed in accordance with all regulations in existence at the time of their construction, unless otherwise noted. NAME (PRINT): SIGN: __________ DATE: ______ _ Note; If the person signing above is an authorized agent for the property owner include form B-62 signed by property owner. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339~2719 Email: 8uilding@cadsbadca.gov 2 REV. 04/22 ~£",'' ,~ ~".;'~'1<~,',: ., '" if ' • "' " • ,-~&.RMIT INSPECTIQN HISTORY for (~~.~-~022 ... 0172)•.,, Permit Type: BLDG-Commercial Work Class: Tenant Improvement Status: Closed" Finaled Application Date: 05/24/2022 Issue Date: 09/29/2022 Expiration Date: 07/31/2023 IVR Number: 40833 Owner: CARLSBAD PLAZA LIMITED Subdivision: Address: 2540 EL CAMINO REAL, # A CARLSBAD, CA 92008-1286 Scheduled Date Actual Inspection Type Start Date Inspection No. Inspection Status Primary Inspector Reinspection Inspection 02/17/2023 02/21/2023 11/06/2023 02/17/2023 BLDG-Fire Final Checklist Item 187968-2022 COMMENTS Failed Felix Salcedo FIRE-Building Final 1 Captive air system fully operationaL Revised approved plans required prior to final sign ofL 2. Fire alarm fully tested and operational. Approved plans required for final sign off. 3. An operational permit is required per CFC 105.5.9. Beverage dispenser shall not be operational until tested and plans are approved. 4. Ok to utilize hood for stock and train only per Tim kersch (building inspector). 02/16/2023 BLDG-Final Inspection Checklist Item 203481-2023 COMMENTS Passed Tim Kersch BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final NOTES Created By Angie Teanio TEXT 909-781-7108 Eric BLDG-Fire Final Checklist Item 225391-2023 COMMENTS Scheduled Felix Salcedo FIRE-Building Final 1. Captive air system fully operationaL Revised approved plans required prior to final sign off. 2. Fire alarm fully tested and operational Approved plans required for final sign off. 3. An operational permit is required per CFC 105.5.9. Beverage dispenser shall not be operational until tested and plans are approved. 4. Ok to utilize hood for stock and train only per Tim kerscl1 (building inspector). Monday, November 6, 2023 Reinspection Incomplete Passed No Complete Passed Yes Yes Yes Yes Yes Created Date 02/15/2023 Incomplete Passed No Page 3 of 3 " < ' , . PERMIT INSPECTION HISTORY for (~~C2022-0172) Permit Type: BLDG-Commercial Application Date: 05/24/2022 Owner: CARLSBAD PLAZA LIMITED Work Class: Tenant Improvement Issue Date: 09/29/2022 Subdivision: Status: Closed -Finaled Expiration Date: 07/31/2023 Address: 2540 EL CAMINO REAL, # A IVR Number: 40833 CARLSBAD, CA 92008-1286 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout No BLDG-34 Rough Electrical No BLDG-44 No Rough-Ducts-Dampers 11/15/2022 11/15/2022 BLDG-84 Rough 196621-2022 Partial Pass Tim Kersch Reinspection Incomplete Com bo(14,24, 34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 No Rough-Ducts-Dampers 11/16/2022 11/16/2022 BLDG-44 196761-2022 Partial Pass Tim Kersch Reinspection Incomplete Rough/Ducts/Dampers Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes 01/10/2023 01/10/2023 BLDG-85 T-Bar, Ceiling 200404-2023 Partial Pass Tim Kersch Reinspection Incomplete Grids, Overhead Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-14 No Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical No BLDG-44 No Rough-Ducts-Dampers 01/26/2023 01/26/2023 BLDG-44 201583-2023 Passed Peter Dreibelbis Complete Roug h/D ucts/D am pers Checklist Item COMMENTS Passed BLDG-Building Deficiency Kitchen hood smoke test ok Yes 01/31/2023 01/31/2023 BLDG-45 Hoods 201925-2023 Passed Tim Kersch Complete Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes Monday, November 6, 2023 Page 2 of 3 Building Permit Inspection History Finaled (city of Carlsbad PERMIT INSPECTION HISTORY for {CBC:2022-0172), Permit Type: BLDG-Commercial Application Date: 05/24/2022 Owner: CARLSBAD PLAZA LIMITED Work Class: Tenant Improvement Issue Date: 09/29/2022 Subdivision: Status: Closed -Finaled Expiration Date: 07/31/2023 Address: 2540 EL CAMINO REAL, # A IVR Number: 40833 CARLSBAD, CA 92008-1286 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Re inspection Inspection Date Start Date Status 10/07/2022 10/07/2022 BLDG-21 193589-2022 Partial Pass Tim Kersch Re inspection Incomplete Underground/Underflo or Plumbing Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-44 193590-2022 Failed Tony Alvarado Reinspection Incomplete Rough/Ducts/Dampers Checklist Item COMMENTS Passed BLDG-Building Deficiency No 10/12/2022 10/12/2022 BLDG-44 193905-2022 Partial Pass Tim Kersch Re inspection Incomplete Roug h/D ucts/Da m pe rs Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes 10/26/2022 10/26/2022 BLOG-24 Rough/Topout 194909-2022 Cancelled Dirk de Roggenbuke Reinspection Incomplete BLOG-91 Complaints 195040-2022 Cancelled Peter Dreibelbis Rein spection Incomplete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency No 10/27/2022 10/27/2022 BLDG-24 Rough/Topout 195062-2022 Cancelled Dirk de Roggenbuke Reinspection Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency No 11/03/2022 11/03/2022 BLDG-84 Rough 195571-2022 Partial Pass Tim Kersch Reinspeclion Incomplete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-14 No Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout No BLDG-34 Rough Electrical No BLDG-44 No Rough-Ducts-Dampers 11/04/2022 11/04/2022 BLDG-84 Rough 195846-2022 Partial Pass Tim Kersch Reinspection Incomplete Combo{14,24,34,44} Monday, November 6, 2023 Page 1 of 3 OFFICE USE ONLY SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE RECORD ID# __________________ 1 PLAN CHECK# _________________ 1 Business Name WNM ENTERPRISES INC Project Address {include suite) 2540 EL CAMINO REAO ST# A Mailing Address (include suite) SAME Business Contad WILLIAM Billy MARISCAL City CALRSBAD City State CA State BP DATE Telephone# 951-751-8846 Zip Code APN# 92008 Zip Code Plan File# Project Contact WILLIAM MARISCAL Applicant E-mail Telephone # billy@wnmgrp.com 951-751-8846 The following questions represent the facility's activities, NOT the specific project description. p app rcant 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 a. Unstable Reactives 12. Radioactives ~~~~~~~~~~~~~?.,~~~~~~~~~~~~i;:tl~~~~~~~~~~~~~Lltl~~£!!1~: If the answer to any of the qu an Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: 0 CalARP Exempt 1. 2. 3. 4. 5. 6. 7. 8. YES NO (for new construction or remodeling projects) D cl Is your business listed on the reverse side of this form? (check all that apply). D cl Will your business dispose of Hazardous Substances or Me<ftcal Waste in any amount? D cl Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? D 0 Will your business store or handle carcinogens/reproductive toxins in any quantity? D cl Will your business use an existing or install an underground storage tank? D cl Will your business store or handle Regulated Substances (CalARP)? D cl Will your business use or install a Hazardous Waste Tank System (Tille 22, Article 10)? D cl 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 0 CalARP Required I Date Initials 0 CalARP Complete Date Initials P : The following questions are intended to idertify the majority of air pollution Is ified 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 al apcdcomp@sdcounty.ca.9011; (858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131. 1. 2. 3. YES NO □ cl □ 0 □ cl 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? 4. □ cl (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. 5. 6. D □ G] 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. cl {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 prcposed project Minor Tenant Improvements Install improvements for a Hamburger food dervice I declare under penalty of perjury that to the best ofmy knowledge and belie/ ~ made~rein are true and correct. WILLIAM MARISCAL __ _l_L _ _____J!_ __ ..,,.. __ ...,.L ________ _ Name of Owner or Authorized Agent Signature of Owner or Authorized Agent FOR OFFICAL USE ONLY: u~ / Lts / LULL Date FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ______________________________ _ BY: ____________________________ _ DATE: __ __._ __ __. __ _ EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMO• APCO COUNTY-HMO APCO COUNTY-HMO APCO .. *A stamp In this box m:!h'. exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permIttIng requirements may still apply HM-9171 (9/18) County of San Diego -DEH -Hazardous Materials Division ENCINA WASTEWATER AUTHORITY INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY 6200 Avenida Encinas, Carlsbad, CA 92011 Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@enclnajpa.com Date: 9-28-2022 Business Name: Mooyah Burger street Address: 2540 El Camino Real Carlsbad CA 92008 Email Address: billy@wnmgrp.com PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT : (ON REVERSE SIDE CHECK TYPE OF BUSINESS) □ Check all below that are present at your facility: DD Acid Cleaning Assembly D Automotive Repair D Battery Manufacturing DD Biofuel Manufacturing Biotech Laboratory D Bulk Chemical Storage D Carwash DD Chemical Manufacturing Chemical Purification D Dental Offices 0 Dental Schools D Dental Clinics D Dry Cleaning D Electrical Component D Manufacturing D Fertilizer Manufacturing D Film/ X-ra y Processing 0 Food Processing D Glass Manufacturing O1ndustrial Laundry D Ink Manufacturing D Laboratory D Machining/Milling D Membrane manufacturing D (i.e. waterfilter membranes) O Metal Casting/Forming D Metal Fabrication 0 Metal Finishing D Electroplating D Electroless Plating □Anodizing D Coating (i.e. phosphating) D Chemical Etching/Milling O Printed Circuit Board D Manufacturing 0 Metal Powders Forming D Nutritional SupplemenWitamin 0 Manufacturing D Painting/Finishing O Paint Manufacturing D Personal Care Products D Manufacturing D Pesticide Manufacturing/ Packaging O Pharmaceutical Manufacturing D (including precursors) 0 Porcelain Enameling D Power Generation 0 Print Shop D Research and Development D Rubber Manufacturing D Semiconductor Manufacturing D Soap/Detergent Manufacturing D Waste Treatment/Storage New Business? YesONo[:) SIC Code(s) if known: Date operation began/will begin: 10-1-2022 Tenant Improvement? Yes (:]NoO If yes, briefly describe improvement : Food service tenant improvement Description of operations generating wastewater (discharged to sewer, hauled or evaporated): evaporated Estimated volume of industrial wastewater to be discharged {gal/ day) : _T_B_D _________________ _ List hazardous wastes generated (type/volume): __ G_re_a_s_e_in_to_G_r_e_a_s_e_l_n_te_r_c_e_;_p_to_r _____________ _ Have you applied for a Wastewater Discharge Permit from the Encina wastewater Authority? YesD Date: _____ No[!] Page 1 of 2