HomeMy WebLinkAbout1605 BUENA VISTA WAY; ; CBC2020-0451; PermitBuilding Permit Finaled
(city of
Carlsbad
Commercial Permit
Print Date: 12/13/2023
Job Address: 1605 BUENA VISTA WAY, CARLSBAD, CA 92008
Permit Type:
Parcel#:
Valuation:
Occupancy Group:
#of Dwelling Units:
Bedrooms:
Bathrooms:
Occupant Load:
Code Edition:
Sprinkled:
BLDG-Commercial
1562001600
$0.00
Project Title: BUENA VISTA RESERVIOR SITE
Work Class:
Track#:
Lot#:
Project#:
Plan#:
Construction Type:
Orig. Plan Check#:
Plan Check#:
Demo
DEV2018-0222
Permit No:
Status:
Applied:
Issued:
CBC2020-0451
Closed -Expired
11/10/2020
11/25/2020
Finaled Close Out:
Final Inspection:
INSPECTOR: Alvarado, Tony
Description: BUENA VISTA RESERVOIR: DEMO OF UTILITIES, RESERVOIR SIDE WALL, AND PUMP HOUSE
Applicant:
LENNAR HOMES OF CALIFORNIA INC
ALAN CHIK
15131 ALTON PKWY, # 365
IRVINE, CA 92618-2386
(949) 204-4628
FEE
Property Owner:
CITY OF CARLSBAD
CURTIS JACKSON
1200 CARLSBAD VILLAGE DR
CARLSBAD, CA 92008-1989
(760) 434-2836
BUILDING PLAN REVIEW -MINOR PROJECTS (LOE)
BUILDING PLAN REVIEW-MINOR PROJECTS (PLN)
Total Fees: $292.00 Total Payments To Date: $0.00
Contractor:
LENNAR HOMES OF CALIFORNIA INC
2000 FIVEPOINT, # 3RD FL
IRVINE, CA 92618-2384
(949) 204-4628
Balance Due:
AMOUNT
$194.00
$98.00
$292.00
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 Pagelofl
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov
( City of
Carlsbad
COMMERCIAL
BUILDING PERMIT
APPLICATION
B-2
Plan Check
Est. Value
PC Deposit
Date 11-I O -2.D2,t5)
Job Address 1605 Buena Vista Way
Tenant Name: Buena Vista Reservoir Site
Year Built: _____ Occupancy: ____ _
Suite:. _____ ,APN: 156-200-16-00
Lot#:
Construction Type;..• ____ _,.ire Sprinklers:S? gA/C:~ g
BRIEF DESCRIPTION OF WORK: Demolition of existing utilities, reservoir side wall, and pump house.
D Addition/New: ____________ New SF and Use, ____________ New SF and Use,
____ Deck SF, Patio Cover SF (not including flatwork)
D Tenant lmprovement: ______ SF,
______ SF,
Existing Use _______ Proposed Use ______ _
Existing Use Proposed Use ______ _
D Pool/Spa: _____ SF Additional Gas or Electrical Features? ____________ _
DD DD DD D Solar: KW, Modules, Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No ----------
□ Plumbing/Mechanical/Electrical Only: ----------------------------
□ Other: Public passive park
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 point of contact throughout the permit process.
PROPERTY OWNER APPLICANT O PROPERTY OWNERS AUTHORIZED AGENT APPLICANT Iii
Name: City of Carlsbad Parks and Recreation Department (Kyle Lancaster) Name: _c_ec_ca_,_IA_1,_,_ch_lk_l _______________ _
Address:3096 Hardin~ Street
City: Carlsbad State:_C_A __ .Zip: 92008
Phone: (760) 434-2826
Email: Afan.Chik@Lennar.com
DESIGN PROFESSIONAL APPLICANT 0
Name: Schmidt Design Group, Inc (JT Barr)
Address: 1310 Rosecrans Street, Suite G
City: San Diego State: CA Zip: 92106
Phone: (619) 236-1462
Email: jtbarr@schmidtdesign.com
Architect State License: ___________ _
Address: 15131 Alton Parkway, Suite 365
City: Irvine State:~Zip:_9_26_1_8 __ _
Phone: (949) 204-4628
Email: Alan.Chik@Lennar.com
CONTRACTOR BUSINESS APPLICANT 0
Name: Lennar (Alan Chik)
Address: 15131 Alton Parkway, Suite 365
City: Irvine State: CA Zip:_9_2_6_1_8 ___ _
Phone: (949) 204-4628
Email: Alan.Chik@Lennar.com
State License: 728102 Bus. License: BLOS1239643
1635 Faraday Ave Carlsbad, CA 92008
B-2
Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
Page 1 of 2 Rev. 08/20
•
( OPTION A): WORKERS'COMPENSATION DECLARATION:
I hearby affirm under penoJty of perjury one of the following declarations:
:::J I have and will maintain a certificate of consent to self-insure for workers' compensation provided oy Section 3700 of tlie Labor Code, for the performance of ~he
work W'1ich this permit is issued.
0 I have and wil1 mamtain worker's compensation, as required by Section 3700 ofthe Labor Code, for the performance of the work for which this permlt is Issued.
My workers' compensation insurance carrier arid policy number are: Insurance Company Name: _____________________ _
Policy No. _____________ Ekplratlon Date: _________ _
D Certificate of Exemption: I certify that in the performance of the work for which this perrrit is issued, I shall not employ any person in any manner so as to be come
subject to the workers' compensation Laws of Callfornia. WARNING: Failure to secure worker5 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,
CONTRACTOR SIGNATURE: _________________ □AGENT DATE: _____ _
( OPTION B ): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
0 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 intendl"d or offered for sale. If, however, the build1nf1 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).
Cl{I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profess101;s 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).
□ I am el(empt under Section ________ Business and Profes~ions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the propos!"d property improvement □ Yes □ No
2. J (have/ have not) signed an application fo a building permit for the proposed work.
3. ! have contracted with the foliowing pe~ (firm) to provide the proposed construction (include name address/ phone/ contractors' license number):
4. I plan to provide portions of the work, bu fiave hired e f lowing person to coordinate, supervise and provide the major work (include name/ address/ phone/
contractors' license number):
5.1 will provide some of the work, but I .ha e co followlng persons to provide the work indicated (include name/ address/ phone/ type of work):
DATE: _10_J_27_1_20 __
CONSTRUCTION LEN DIN AGENCY IF ANY:
I hereby affirm that there ls a cons ruction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Clvil Code).
Lender's Name: ____________________ _ Lender's Address: ____________________ _
ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY:
Is the applicant or future building occupant req ulred to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? /'J Yes n No
Is the applicant or future building occupant required to obtain a pertnIt f,om the air pollution control district or air quality management district? :1 Ye~ 0 No
ls the facility to be constructed withn 1,000 feet of the outer boundary of a school site? □ Yes □ No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
APPLICANT CERTIFICATION:
I certify that I have 'ead the application and state that the above information is correct and tha~ the intormation 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 SAVE, INDEMNIFY AND KFEP
HA~MLESS THE CITY OF CARLSBAD AGAINST ALL UAB1UTIES 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 equiredforexcavat•ons over S'O' deep and demo!ition or construction of structures over 3 storil"s in height
by such pt'rmit is not commenced within 180 da
aher the work is commenced for a period of 1
1635 Faraday Ave Carlsbad, C
B-1
s of this Code shall el(pire by limitation and become null and void if the building or work authori2ed
,CLO or if the building or work authorized by such permit is suspended or abandoned at any lime
Buil ·ngCode).
Ph: 760-602-2719 Fax: 760-602-8558
Page 2 of 2
10/27/20
Email: Building@carlsbadca.gov
Rev. 06/18
( City of
Carlsbad
OWNERS
AUTHORIZED
AGENT FORM
B-62
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
OWNER'S AUTHORIZED AGENT FORM
Only a property owner, contractor or their authorized agent may submit plans and applications for building
permits. To authorize a third•party agent to sign for a building permit, the owner's third party agent must bring
this signed form, which identifies the agent and the owner who s/he is representing, and for what jobs s/he
may obtain permits. The form must he completed in its entirety to be accepted by the City for each separate
permit application.
Note: The following Owner1s Authorized Agent form is required to be completed by the
property owner only when designating an agent to apply for a construction permit
on his/her behalf.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Property Owner Acknowledgement, the execution of which I understand is my personal responsibility,
I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary
to obtain an Owner-Builder Permit for my project.
Demolition of concrete water reservoir and associated utility lines
Scope of Construction Project (or Description of Work): ____________________ _
1605 Buena Vista Way, Carlsbad, CA 92008 Project location or Address: ______________________________ _
Kyle Lancaster, City of Carlsbad 760-434-2941 Name of Authorized Agent: __________________ Tel No. _________ _
Address of Authorized Agent 799 Pine Ave., Ste. 200
Carlsbad, CA 92008
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and certify its accuracy.
Kyle Lancaster rng·1tallysigned by Kyle Lancaster
Date: 2020 10.28 11 :20.26 -07'00' Property Owner's Signature: ____________________ Date: ______ _
DEMOLITION ASBESTOS CERTIFICATION
ADDRESS: 1605 Buena Vista Way, Carlsbad, CA 92008
USE OF BUILDING TO BE DEMOLISHED: _.....:.P..::u.;.;.m;..i;p....:h.;.;;oc=u;;;.se:;;.. _________ _
SQUARE FEET Pump house (JOO SF) X NUMBER OF STORIES ____ _
PROPERTY OWNER: Cit of Carlsbad --='--"-.:....::===------------------ADDRESS: 799 Pine Ave., Suite 200, Carlsbad. CA 92008 PHONE (760) 434-2941
APPLICANT: Alan Chik (Lennar)
ADDRESS: 15131 Alton Parkway, Suite 365, Irvine, CA 92618 PHONE (949) 204-4628
Section 19827.5 of California Health and Safety Code states in part:
"A demolition permit shall not be issued by any city ... as to any building or other
structure except upon receipt from the permit applicant of a copy of each written
asbestos notification regarding the building that has been required to be submitted
to the United States Environmental Protection Agency or to a designated state
agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that the
notification is not applicable to the scheduled demolition project."
As applicant for a demolition permit in the City of Carlsbad, I certify that; I have
read the excerpt from Section 19827.5 of the Health and Safety Code provided
above; the information I have provided on this form is true and correct; and I further
certify the following:
(X. ) On the attached _4 __ pages are copies of all written asbestos notifications
regarding the above referenced building that are required to be submitted to
the United States Environmental Protection Agency or to Part 61 of Title 40
of the Code of Federal Regulations, or successor to that part.
( ) notification is not applicable to the
11/03/2021
Appl"cant s Signature
I
Date
Rev. 711120
<18 LAB
November 01 2020
JT Ba~r
Schmidt Design Group
1310 Rosecrans Street
Unit G
San Diego CA 92106
OFFICE B5B.368.951 9
FAX BSB.36B.9529
INF"O@MCBILABBUBA.CCM
923S TRADE PLACE, SUITE J•SAN DIEGO CA 92126
Re LImIted Asbestos Survey Report -Rece1ved on October 30 2020
Schmidt Design Group
IntersectIon of Buena Vrsta \Vay and Arland Road
Carlsbad CA 92008
Work Order/Claim#: n/a
Mobilab Project#: 22657
Limited Asbestos Survey
1.Dtroc;!uction
This report presents the results of Ifie :im1ted asbestcs-conta1ning matenal 1ACfV) survey c0'lducted by Mob1Lab Environmental
Deterr111nat1ons USA LLC for the potential abatement at the above-referenced site
The asbestos survey was r·estricted to the materials to be d1stwbed ty the c:emol1t1on of the residence anci/or at the direction of c!a11~s
adjuster and/or contractor. The following materials were sampled
Sample Number Location Buildina Material Tvoe
1a Shed Roof Felt
2a Shed Roof Felt
3a Pioe Exterior Side Buildina lrisulat1on
Pioe Exterior Side Bu1ld1na Insulation
4a P1oe Exterior Side Bu1ldina Insulation
PIoe Exterior Side BuIldIna insulation
5a Shed Roof Stucco
6a Shed Roof Clav Tile
7a Shed Interior Ce1l1nq Plaster
Shed Interior Ceilina Piaster
7b Shed Interior Ceil1na Mastic
Ba Shed Interior Ce1l1na Plaster
Shed Interim Ce1l1na Plaster
Sb Shed Interior Ceilino Mastic
9a Shed Interior Ceilina Plaster
Shed Interior Ceilinq Plaster
9b Shed Interior Ce1l1na Mastic
10a Shed Interior Wire Insulation
11 a Shed P1oe Gasket Gasket
12a Shed Interior Flooring Cement
12b Shed Interior Fioonnn Cement 13a Reservrnr Interior Wall Cement 14a Reservoir Interior Wall Cement
14b Reservo11· Interior Wal! Mastic
15a Reservoir Interior Wall Cement
16a Reservoir Interior Wall Caulk1'1n
17a Reservoir Interior Wall Caulkina
Other areas or materials at the site were not surveyed
Materials suspected of containing asbestos and scheauled to be d1sturbed by possible demo!ition/n.batement appear 1n the attached Data
Summary Report. The asbestos survey was restricted based upon H1e possible abatement. If rev1s1ons are made that impact add1t1ona1
materials or areas, it is important that Mob1Lab Environmental Determinations USA. LLC be contacted to review the changes andior
conduct add1!1onal asbestos survey work to address potential impacts to untested materials No previous asbestos survey reports were
provided for review No as-bdrlt construction records were provided fm review
Suspect materials to be disturbed by possible repairs were sampled 1n accordance with the federal EPA AHE.RA protocols Suspect
materials were grouped and class1f1ed as homogeneous materials based on their color. texture and time of coristruct1on Similar appearing
materials in different construction phases of a building are classified as separate materials. Materials determined by the inspector to be
non-suspect such as wood metal. glass and fiberglass 1nsulat1on were not sampled Add1t1ona1 u:itested materials may be present behind
walls. column enclosures or similar areas. or 1n inaccessible areas such as locked rooms
Samples were collected in such a manner as to minimize release of t11e material into the surroundings Material type, sample number.
sample location and other pertinent !nformation were recorded at the time of the sampling Each sample was placed 1n an airtight
polyethylene bag labeled with a unique number. Samples were analyzed using polarized light microscopy (PLM) with dispersion staining
and using visual area estimation to determine percent asbestos content 1n accordance with EPA Method 600/M4-82-020 and 600R/-93-116
or using Fauna Transformation Infrared (FTIR) 1n accordance with /.i..STM E168-99 or ASTM E1421 to determine percent asbestos content
These methods allows for the 1dent1ficat1on of the primary types of asbestos used in building materials The lower l1rn1t of detection for these
methods is one percent Samples co:1taining less than one pe:-ce'lt asbestos are reported as trace
EJIW_ir,g~
Lab report follows -Red or Yellow h1ghl1gf-its and/or asterisk 1n "Type of Fiber Observed" column 1nd1cate asbestos was present 1n the
sample
As_l:>estos Test Be port: E£'8 Method 600/M4-82-020 and 600R/-9.3.-116 or ASTM E168-99 and ASTM E1421
ML Analyst Date Building Area* Sample Location Sample Physical Type of Fiber Estimated Date
# Collected Material T e Color Condition Wei ht% Com leted
1a 4 2020-10-30 Felt Shed Roof Black Non-Friable Plant material / Non-Asbestos 2020-11-01 a er 40-60%
2a 4 2020-10-30 Felt Shed Roof Black Non-Friable Plant material / 2020-11-01
5a Stucco Shed Roof
4 Clay Tile Shed Roof Red Non-Friable N/A Non-Asbestos 2020-11-01 6a N/A
4 Plaster Cream Non-Friable Plant malarial / Non-Asbestos 2020-11-01 a er 2-5%
?a
4 Plaster Cream Non-Friable Non-Asbestos Synthetic 2-5% 2020-11-01
7b 4 Mastic Black Non-Friable N/A Non-Asbestos 2020-11-01
Ceilinn
4 2020-10-30 Plaster 1 Shed Interior Cream Non-Friable Ceilinn
Ba Notes: Samnle nround in a mortar and oestle.
Shed Interior 4 2020-10-30 Plaster 1 Ceilinn Cream Non-Friable
Notes: Samnle round in a mortar and Jestle
Sb 4 2020-10-30 Mastic 1 Shed Interior Black/Silve Non-Friable Ceilinn
4 2020-10-30 Plaster 1 Shed Interior Cream Non-Friable Ceilino
9a Notes: Samnle nround in a mortar and nestle
Shed Interior 4 2020-10-30 Plaster 1 Ceilinn Cream Non-Friable
Notes: Samnle round 1n a mortar and estle.
9b 4 2020-10-30 Mastic 1 Shed Interior Black/Silve1 Non-Friable Ceilinn
10a 4 2020-10-30 Insulation 1 Shed Interior Wire Black Non-Friable
11a 4 2020-10-30 Gasket 1 Shed Pipe Gasket Red/Cream Non-Friable
4 2020-10-30 Cement 1 Shed Interior Pink Non-Friable 12a Floorin□
Notes: Samnle nround in a mortar and nestle.
4 2020-10-30 Cement 1 Shed Interior Cream Non-Friable 12b Floorina
Notes: Samnle nround in a mortar and nestle
4 2020-10-30 Cement 1 Reservoir Interior Cream Non-Friable 13a Wall
Notes: Samnle nround in a mortar and nestle.
4 2020-10-30 Cement 1 Reservoir Interior Cream Non-Friable 14a Wall
Notes: Sa mole around in a mortar and oestle.
4 2020-10-30 Mastic 1 Reservoir Interior Black Non-Friable 14b Wall
Notes: Samnle round In a mortar and nestle.
4 2020-10-30 Cement 1 Reservoir Interior Cream Non-Friable 15a Wall
Notes: Samnle round in a mortar and nestle
16a 4 2020-10-30 Caulking 1 Reservoir Interior Black Non-Friable Wall
17a 4 2020-10-30 Caulking 1 Reservoir Interior Black Non-Friable Wall
Area: 1. < 1000 sq ft 2: 1000-5000 sq ft, 3: >5000 sq ft
Approximate measurements only, not for bidding purposes Laboratory reports are attached.
Limitations
N/A
Plant material / Non-Asbestos 2020-11-01 naner 2-5%
Non-Asbestos Synthetic 2-5% 2020-11-01
N/A Non-Asbestos 2020-11-01 N/A
Plant material / Non-Asbestos 2020-11-01 oaner 2-5%
Non-Asbestos Synthetic 2-5% 2020-11-01
N/A Non-Asbestos 2020-11-01 N/A
Plant material / Non-Asbestos 2020-11-01 oaoer >60%
N/A Non-Asbestos 2020-11-01 N/A
N/A Non-Asbestos 2020-11-01 N/A
N/A Non-Asbestos 2020-11-01 N/A
N/A Non-Asbestos 2020-11-01 N/A
N/A Non-Asbestos 2020-11-01 N/A
N/A Non-Asbestos 2020-11-01 N/A
N/A Non-Asbestos 2020-11-01 N/A
Plant material / Non-Asbestos 2020-11-01 oaoer 5-10%
Plant material / Non-Asbestos 2020-11-01 naner 5-10%
Samples were collected from v1s1ble and accessible areas only. No excavation or demolition activites were included as part of this limited
survey. If revisions to the renovation project are made that impact additional materials or areas, it is important that Mobilab Environmental
Determinations USA, LLC be contacted to review the changes and/or conduct additional asbestos survey work
Mobilab Environmental Determinations USA. LLC has performed this asbestos sampling in a substantial and workmanlike manner in
accordance with generally accepted methods and practices of the profession, and consistent with that level of care and skill ordinarily
exercised by reputable environmental consultants under similar conditions and circumstances. No other representation, guarantee or
warranty, express or implied, is included or intended in the asbestos survey report
Conclusion
Sample results for a material that are greater than one percent asbestos are class1f1ed as ACM under regulations promulgated by {but not
limited to) the following agencies federal EPA, San Diego Air Pollution Control District (SDAPCD), California EPA (Cal-EPA), federal OSHA
and Cal/OSHA. The agencies use the following definitions:
Federal EPA: materials containing greater than one percent asbestos are ACM
SDAPCD: materials containing greater than o.'le percent asbestos are ACM
Cal/OSHA. materials contaInIng greater than O 1 % asbestos by weight are ACCM
CCLB: materials containing greater than O 1 °/u asbestos by weight are ACCM
If more than 100 squar·e feet of ACCM Is disturbed. the work must be conducted by a DOSH registered contractor
Materiais containing more than one-tenth of one percent asbestos also rea0Ire licensing fo: asbestos with the CCLB and regIstrat1on with
Ca,1OSHA
SCAQMD -Rule 1403 and SDAPCD -Rule 1206 requires that for every dernolIt1on or for every renovation 1nvolv1ng the removaI of 100
square feet or greater of Regulated Asbestos Containing Ma1enc1i ( R4CM). a not1frcat1on must be made to the SDAPCO at least 1 O working
days prior to commencement of demolitIon/renovat1on
Under the Cal1forn1a Health and Safety Code Sectio'ls 259'15 et seq. not1f1cat1on about asbestos comaIning construction rnater1als must
be provided 1n1t1ally by tt1e buIld1ng owner within 15 days of receipt of the information to co-owne-s. tenants. employees. contract workers
or others who may encounter the matena! The notification n1Ust be Drov1ded annually thereafter
For detailed regulatory requirements In specific situations Mob1Lab EnvIronrnentai Deterrn1nat1ons USA. LLC shoula be consulted. or the
applicable regulations should be examined
If you have any q~Jest1ons please call 'lle at 858-368-9519
Sincerely.
Mobilab Environmental Determinations, LLC
Greg Coons
Chief Operating Officer
CDPH ST #25920. Cal DOSH CAC #18-6336
Chief Operating Officer
CDPH ST #25920. Cal DOSH CAC #18-6336
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October 30. 2020
JT Barr
Schmidt Design Group
~310 Rosecrans Street
Unit G
San Diego CA 92106
Re Suspect lead con1a·1n1ng material sarnple analysis
Schrnidt Design Group
intersection of Buena Vista Way and Arland Road
Caclsbad CA 92008
Work Order/Claim# n.:a
Mob1Lab Project # 22658
Dear JT Barr
□F'F"ICE BSS.369.95 1 9
FAX BSB,36B,9529
INFC@MCBILABSUSA,CCM
9235 TRADE PLACE, SUITE J•SAN DIEOO CA 921 26
t~
On October 30, 2020 a Mob1Lab technician used an XRF lead analyzer to test two (2) sample(s) from one or mo~e structures located~
1,1tersect1on of Buena Vista Way and Arlat1d Road Carlsbad CA 92008 (H1e "Site") T'ie samples were ana1.yzed for ·1ead content [~--;:r..,11
This lead based paint and lead based coating (1 e cerarnic tile) survey was conducted m order for the contractor to protect workers fras:P~:-:9
lead exposure and comply with applicable regulato:y ngenc1es st1ould lead be fo;.md 1n areas scheduied for demol1l1on/renovation Th~ ..
limited survey 1s 1,ntended to g·1ve representative information mgard1ng lead co11centrat1on in construct1on materials scheduled for rem \/,.~ .. _.:
This survey 1s not being done as a Lead Hazard Evaluation as defined by the Cal1for'l1a Department of Public Health (COPH) 1n CCR, 1
17
Lead Assessor Laboratory Report
Red h1qhl1ghts and/or aster1sk 1n 'Component" colL;mn 1r1d1cate ieao was present 1n concentrations that exceed regulatory or Lea,j Safe
Work practice thresholds as defined by the applicable regulatory agencies listed below
ML Sample
ID
01
Tech ID Location Component Substrate Color Condition Reading
m /cm2
0 1
Samples were found to contain lead and/or exceed locally defined Safe Lead Work
Practice action levels.
r,fob1L.ab has perfo0med representative sampii•1g of iaent1fieC s;,rfaces scheduled for re•nodeiirenovat1on
Regulatory Thresholds by Agency
EPA/HLJO,'CDPH '1 0mg.:crn2• 5000 PPfv1 0 5% by we1gnt
Location Specific Lead Safe Work Practice Action Level
City of San Diego, California· 0.5mg/cm
County of Los Angeles, California· 0.7mg/cm
This report is not to be considered a Lead Hazard Assessment. This report has been compiled per request to allow onsite contractors to
protect workers in compliance with 8 CCR 1532.1. MobiLab Environmental Determmations has performed representative sampling of
identified painted and potential lead based coating (i_e. ceramic tile) surfaces scheduled for demo!it1onlrenovation. Should any additional
painted or potential lead based coating surfaces not covered or listed in this report be identified on the jobsite, said surfaces must be
assumed to contain lead.
These recommendationslfmdmgs are based upon visual inspection and/or samples taken and are limited to the time, place and manner of
the samples collected at the Site and are further limited by the variability associated with the inspection methodology established by
mdustry guidelines. These results/report are not to be considered a guarantee as to health or habitability. The results reported by Mob1Lab
Environmental Determinations cannot be interpreted in any way as an mdication that the Site is or is not free from conditions that could
pose a risk to human health or safety, nor of the suitability of the Property for any purpose whatsoever. No other representation, guarantee
or warranty, express or implied is included or intended in the report.
If you have any questions please call at your earliest convenience
Sincerely,
Mobilab Environmental Determinations, LLC
Joseph McKay
Consultant & Lead lnspector/Assesor
CDPH I/A #LRC-2466. ABI #081 SABCA 116704
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS
QUESTIONNAIRE
OFFICE USE ONLY
RECORD ID# _________________ -l
PLAN CHECK# -----------------J
BP DATE
Business Name Cit of Carlsbad
Project Address {Include suite)
1605 Buena Vista Wa
Maili~ Address {include suite)
/99 Pine Ave., Ste. 200
Business Contact
K le Lancaster
City
Carlsbad
City
Carlsbad
State
CA
State
CA
T8ephone #
760
Zip Code
92
Zip Code
92008
Project Contact Applicant E-mail Telephone#
Alan Chik Lennar Alan.Chik wLennar.com
434-2941
APN#
156-200-16-00
Piao File#
The followlng questions represent the facility's activities, NOT the spe c project description.
PA ocess, or store a
ap ,cant must contact the Fire Protection Agency with jurisdiction prior to plan submittal.
Occupancy Rating: Facility's Square Footage (including proposed project):
5. Organic Peroxides 9. Water Reactives 13. Corrosives 1 . Explosive or Blasting Agents
2. Compressed Gases
3. Flammable/Combustible Liquids
6. Oxidizers 10. Cryogenics
7, Pyrophorics 11. Highly Toxic or Toxic Materials
14. Other Health Hazards
15 None of These.
4. Flammable Solids 8 Unstable Reactives 12. Radioactives
questionsisyes,applioantmuslcontactl Countyo San iego
Call (858) 505-6700 prior to the issuance of a building permit.
: If the answer to any of the
an Diego, CA 92123.
FEES ARE REQUIRED Project Completion Date: 4/ 12/21 Expected Date of Occupancy: 4121121 (for new construction or remodeling projects)
0 CalARP Exempt
1
2.
3.
4
5
6
7.
8
YES NO
□ llil fs 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? □ [l!I
□ Ill 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 □
[]I Will your business store or handle carcinogens/reproductive toxins in any quantity? rn Will your business use an existing or install an underground storage tank?
[XI Will your business store or handle Regulated Substances (CalARP)?
[E Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 0 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
Date lntials
0 Ca!ARP Complete
I
Date Initials
The following que.stioos are intended to identify the majority of air poflution
d by these questions. Some residential projects may be exempt from APCO
requirements. If yes is answered for eUher questions 1, 2 or 5 or for more CQJ'llprehensive requirements, please contact APCD at apcdcomo@Jdcounlv,ca,goy;
(858) 586¥2650; or 10124 Old Grove Road, San Diego, CA 92131. Per Lhc asheslo., report, the area l(Jnlaining a~]w,10~ i.<, lou1ted on the pipe ,1t
Y~S NIJIO tlw ('Xttriur llf tlw pump ho11sc (l'llll1!' )wu~c i~ 10\8'). The ,lrf'rl of rnnn·rn i~
1 L. Will the project disturb 100 square feet or more of existing building materials? 1 1 1 r, D css I 1.111 s;n ~F P case ,cl· allarhcd ,1shc,10, ~!HVl'Y n·p1>rt
2, L!.l Will any load supporting structural members be removed?
3. IZl D {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 gg D (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 ([I D 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
6 IXI D {ANSWER ONLY IF QUESTION 5 IS YES) Will the projecl or associated construction equipment be localed within 1.000 feet of a school
bounda ?
Briefly describe business activities:
City of Carlsbad (Parks De artment) ark.
I declare under penalty of perjury that to the best of my knowledge and belief Authorized Agent (Alan Chik)
Name of Owner or Authorized ent SI tureofOwnerorAuthorized
11 / 03 / 2020
Date
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION
BY: DATE: I I
EXEMPT OR NO FURTHER INFORMATION REQUIREO RELEASED FOR BU ILD1NG PERMIT BUT NOT FOR OCCUPANCY RELEASEO J=OR OCCUPANCY
COUNTY-HMO" APCD COUNTY-HMO APCD COUNTY-HMO APCD
o"'on if " ~ Reviewed ()
<( 11/0'J/20 -ALF~ ¼
~ OM17/fmtials _/J;
,:;,"'): .;£.> "~ .. () Q e \l('I . A stamp in this box.Q!ID! exempts businesses from completing or updating a Hazardous Materials BIJShess Plan, Other perm1tt1ng requirements may stlllapply
1111 9171 19118) G0t1otx or §pg Qj0(3Q-PEH -HPYUPPIPi Mans OMsion