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Home My WebLink About2525 EL CAMINO REAL; 200; CBC2022-0415; Recycle• (city of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbodco.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 Management at 442-339-9400, a certified C&D recycler, or the Carlsbad Building Division at 442-339-2700. Please note: Unless you are self-hauling, Waste Management or approved haulers must be used for all construction projects within the City of Carlsbad. Applicant Information Permit No. C E{,:1(f22-CJLJ I:; Project Title _M_a_s_F_u_e_g_o_T_I _________ _ ProjectAddress2525 El Camino Real #200 Carlsbad, CA 92008 Applicant Name Nguyen Trang O ''~)°' Last First Applicant Address 11640 Warner Ave. Fountain Valley, CA 92708 APN Architect 0 Phone 1_714 j 496-5650 E-mail Address jan@gCSCOnStrUCt.COm Applicant Mailing Address 11640 Warner Ave. Fountain Valley, CA 92708 (if different than project address) Project Type /check all that apply): Brief Description Tenant Improvement (Restaurant) Other 0-- Project Size 7694 SOFT Estimated Cost of Project $_1_8_5_,_o_o_o ___________ _ (square footage) Please check the appropriate box: D I plan on using REPUBLIC SERVICES roll-off bin(s) for all materials and will provide all receipts after construction. !✓I 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 Trang Nguyen Signature~~ Date 04/02/2023 Page 1 of4 Rev.04/22 DEBRIS RECYCLING ESTIMATE: SECTION A Permit No. ____________ Project Title Mas Fuego Tl Project Address 2525 El Camino Real #200 Carlsbad, CA 92008 APN Applicant Name_N~g~u~y_e_n __________ T_ra_n~gc__ ______ Phone (714) 496-5650 Last First 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. Material Type Complete this line of the table only if only using WASTE MANAGEMENT roll-off bins. Mixed C&O Debris Parking lot Asphalt & Concrete Brick/ Masonry/ Tile Mixed Inert Debris Cabine ure indows (circle all that apply) Car et Carpet Padding/ Foam Cardboard Ceiling Tile {acoustic) Drywall (used, new, scrap) Landscape Debris {brush, trees, stumps, etc.) No dirt. Unpainted Wood & Pallets Concrete Roofing Materials Scrap Metal Stucco Other: Trash/Garbage TOTAL SECTION C Goal: the diversion rate shall be 65% b weights of debris. Estimated Waste Quantity (tons) 1.75 24 .75 .1875 2 .64 3 1 2 35.32 A B C Place a(✓) check next to items to be reused or salvaged Place a(✓) check next to items to be recycled ✓ Place a ( ✓) check next to items to be disposed at landfill To meet 65% Diversion Requirement (estimate) 35.31 Total Estimated Waste from above Minimum Required Diversion Contractor/Owner Signature. ~.1%_\;\l~_,-..,""°===---'. ____ Date 4 /2-/uz2/2 .. I Page 2 of 4 Rev. 7l1i20 " 1·-;;-AR:r 2 ---c(~tnplete before final inspection; obtain City Approved hau!er receipts and return prior to final L building approval. 7 j DEBRIS RECYCLING REPORT (ACTUAL): 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. Address 11640 Warner Ave Fountain Valley, CA 92708 Date 09/20/202:1, ------------ .~se th!~ Fini1I tog _below to t11a~k~a~ •. <>1• n1iltefials ~~ ~h!IY-!eay~-tnei JQb-slte, @@SAVE l!ECEll!TS@@ • Indicate flNAL quantities .in tQns fo~eath "1aterfal andsavere¢eip1$i~d~o&i!lient$lroinfacllities where material is taken. Additional Proje-~ L~ge-s are available if ~ecessaiy, Qse City Cc,nversion Table tQ convert volume to tons. Date Material Type A B C Actual Amt Reused or Salvaged Actual Amt Recycled Actual Amt Disposed in Landfill Destination Facility (Name, Address, Phone) f_~qmple: 01/01/2020 Concrete (broken) 5 tons Palomar Transfer Station, 5960 El Camino Real C&D Trash C&D 04/15/2023 06/15/2023 07-14-2023 09/07/2023 ------------ C&D Diversion Rate Achieved 12.2 I- -------·------(760/ 603-0153 4.2 tons rallbronk Wa~te & Recycling ~5:Q West Avia_ti_<_2_n (76_()) 7_28_-_6114 5.32 l{nruhl1c Scrv1rns, Irie VcNIO< kelPrcs com, """"'Y PNSSOfl JI ' w,o '.1%1) _J 17.52 -------- Total of columns A+ B Total of columns A+ B + C DIVERSION Contractor/Owner Signature ----~- Attach the following documentation to this Report: Original recycling weight tickets, landfill weight tickets Original donation receipts with photos and/or itemized descriptions Any other relevant information to support Recycling Report _ Date 09/20/2023 Return completed form and documentation to: City of Carlsbad Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 RECORD COf",;i Page3of4 City of Carlsbad SEP 21 2023 BUILDING DIVISION Rev. 04/22 \ ' RECORD C FALLBROOJC WASTE & RECYCLING 550 NEST AVIATION FALLBROOK, CA .92028 (760) 728-6114 CUstomer: 0000 City of Carlsbad SEP 21 2023 66164 04/15/23 INVOICE In: 7:06 Truck: 0000 Out: 7:31 Container: Route: 05354 Origin: 053 CARLSBAD 1,W 1bM cfy>