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Home My WebLink About2180 RUTHERFORD RD; ; CBC2023-0230; RecyclePART 2 Complete before final inspection, obtain City Approved hauler receipts and return prior to final building approval. 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. Permit No. CBC2023-0230 Print Name Jeff Denny ----'-----------------! Address SECTION B _2_1_ao_R_u_th_e_rfo_r_d_R_d_, _c_a_rls_b_a_d _______________ Date 4/4_/_24 _________ -l 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. A B C Actual Amt Reused or Salvaged Actual Amt Actual Amt Destination Facility (Name, Address, Phone) Date Example: 01/01/2020 2/2/24 3/5/24 SECTION C Material Type Concrete (broken) C&D C&D <D>TOTAL Recycled Disposed in Landfill 5 tons .92 .74 1.66 Palomar Transfer Station, 5960 El Camino Real -760 603-0153 Palomar Transf9f Station, 5960 El Camino Real -(760) 603-0153 PaJomarTransf9f Station, 5960 El Camino Real· (760) 603--0153 Diversion Rate Achieved 1 .66 / 1 .66 = 100 % Total of columns A + B Total of columns A + B + C DIVERSION n ~--111'-0.W,. Contractor/Owner Signature , leffenny =r--·"" • 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 4/4/24 Return completed form and documentation to: City of Carlsbad Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 City of Carlsbad MAY 1 ~ 2024 RECORD COPY Page 3 of 4 BUILDING DIVISION Rev. 04122 PART 2 Complete before final inspection, obtain City Approved hauler receipts and return prior to final building approval. 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. Permit No. CBC2023-0230 Print Name Jeff Denny -------------------2180 Rutherford Rd, Carlsbad Address Date4/4/24 ------------------------------------- SECTION B Use this Final Log below to track loads of materials as they leave the job site. @@SAVE RECEIPTS@@ Indicate FINAL quantities in 1Qm 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 Reused or Salvaged Actual Amt Actual Amt Recycled Disposed in Landfill Destination Facility (Name, Address, Phone) Example: 01/01/2020 Concrete (broken) 5 tons Palomar Transfer Station, 5960 El Camino Real -760 603-0153 2/2/24 C&D .92 Palomar Transfer Slation, 5960 El Camino Real• (760) 603-0153 3/5/24 C&D .74 Palomar Transfer Station, 5960 El Gamino Real • (760) 603-0153 @TOTAL 1.66 SECTION C Diversion Rate Achieved _1_.6_6 ______ ~/_1_.6_6 _________ =_1_0_0 ___ % Total of columns A + B Total of columns A + B + C DIVERSION Contractor/Owner Signature , left Denny ye.:-,-__ .,._ .... Date 4/4/24 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. 04122 ,,, -, Republic Services, Inc. IA 1 c·lc'olull1LILA 0 -:-lwl--~A 1.1v.·;r,.,~~ .wa,1H1HMl1111,f4iilfuih,lt1•Ill•IPl l•U!l:ii-,l•biffll Container ID# 661-2000019 661-2000019 m11x,11m Site Name CALLAWAY GOLF ND-TKT CALLAWAY GOLF ND -TKT Site Address 2180 RUTHERFORD RD 2180 RUTHERFORD RD Container Name 40YD ROLL OFF C&D 40YD ROLL OFF C&D *Small containers are not weighed. Weights provided for small containers are only estimates and are based on your container size multiplied by the number of sch, , Service Period 2/2/2024 3/5/2024 Container Size 40.00 40.00 Container Qty Compactor ' Description CONSTRUCTION AND DEMOLITION CONSTRUCTION AND DEMOLITION Waste Type RECYCLE RECYCLE ~du led hauls per month multiplied by the assumed weights of 1 00lbs per cubic yard for waste or S0lbs per cubic yard for recycling. Account Type Permanent Permanent 00 ::, ::, nn ~~