HomeMy WebLinkAbout1747 BONITA LN; ; CBR2022-1494; Recycle{city of
Carlsbad
Develooment Services CONSTRUCTION WASTE I
MANAGEMENT PLAN
Building Division
1635 FaFOday Avenue
"' r n ,-... i) _ B-59 • ~ ';-i -760-602-2719
WWW. carlsbadca. gov
L.
MAY O 2 2022
r~• I t ~r)
A ppl ica bl e t o ~LL N EW CO N SRUCT I O N, ADD I T IO N S A l}J);:>1 A,l'TERAT.I O N!S. i'i'ou 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 (760) 929-9400, a certified C&D
recycler, or t he Carlsbad Building Division at (760) 602-2700. Please note: Unless you are self-hauling, Waste
Management or approved haulers must be used for all construction projects within the City of Carlsbad.
PART 1 Complete and submit this form when applying for a Building Permit. Note: Permits will not be issued
without a completed Construction Waste Management Plan.
Applicant Information
Permit No. _____________ Project Title TEAM RESIDENCE ADU
Project Address 1749 BONITA LN APN
Applicant Name. CAROLYN SUE TEAM Architect
□
Last First
Applicant Address 17 49 BON IT A LN , CAR LS BAD, CA 92008
Phone 760 419.4430 E-mailAddress TEAMPTG@MSN.COM
Applicant Mailing Address 1749 BON ITA LN , CARLSBAD , CA 92008
(if different than project address)
Project Type
(check all that apply):
Residential
[Z]
Commercial
□
Public Building □.
205-080-18-00
Other
□
Brief Description CONSTRU<;:T A NEW 498 SF SINGLE STORY DETACHED ACCESSORY DWELLING UNIT
ProJ·ect Size 498 Estimated Cost of Project$ 110,000 ----------------------------(square footage)
Please check the appropriate box:
j ✓I I plan on using WASTE MANAGEMENT roll-off bin (s) for all materials and w ill provide all receipts aft er construction.
DI plan on self-hauling to a certified recycling facility and will provide all receipts after construction.
□ This is a proposed LEED certified project and I plan on separating materials on site in conjunction wit h WASTE
MANAGE MENT.
Acknowledgement: I certify under penalty of perjury under the laws of the State of California that t he information
provided in and with t his 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 CAROLYN SUE TEAM Signature ~ k, ~e ~-J,t cJ0,:J-.;)...
Page 1 of4 Rev. 2.10.21
'PART 2 I I
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 t he laws of the State of California that the informat ion provided in and with
this form pertains to construction and demolition debris generated only from the project listed in PART 1, t hat I have
reviewed the accuracy of the informat ion, and that the informat ion is true and correct to the best of my knowledge
and belief.
------
Permit No. C. (!> ~ 2.. 0 & 'l. -/ Lf Cf 4 _____ PrintName 6,-~~Y Uttr-1
/ 74 7 ,lipn}l:g Lu1 e I C qi' I $ b ctJ 9 :2.. ~o Y ~ Date '1 -2..._5-J.. 3 Address
Use this Final Log below to track loads of materials as they leave the job site.
<O><O>SAVE RECEIPTS<O><O>
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
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
q'--{;i_-).) c:_o,ttt..ct-e.Z~,, /_±o -----+,/\4~-¥S 7H2-'l33-3316
i 0-'-{-Ll,, c feAA. S) l/ J.it-I--1--------l-L..>......-'.'-I .t~---+----
3-Jq-J.3j M'15~,t:s!:if;,~l(f{f 7~,-T,~~;~~~~~~
/ -).t/·lS /1\~~~foe~t~,~~ ~~AJ/~~7~~;~ y
i'ht'014_3 h. l ca._t'J. b tl"Ct..i'j ,ec.yt:.\f_ ,of 11
Ok--t-
@TOTAL
SECTION C
Diversion Rate Achieved ---/ __ _
Total of columns A + B Total of columns A + B + C
%
DIVERSION
Contractor/Owner Signature ~~ _____ Date Cf-2..5 ~2.J
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
~
MANZANO
HAULING INC.
ROLL-OFF SERVICES
Job Site
1749 Bonita Rd. Carlsbad
Qty
2
Description
lowboy-clean d irt
To
Payment Terms
Due on receipt
INVOICE
Dale: 10-4-2022
INVOICE # 1271
Ken Construction
km1constQ";,cox.nct
760-443-1822
Unit Price Line Total
$550.0C $1.100.0C
Total $1,100.0C
Make all checks payable to Manzano Hauling Inc.
Thank you for your business!
Escondido Resource Recovery
1021 W Mission Ave
Escondido . CA 92025 (760) 745-3203
Customer: 0000 Ticket: 3924
Date: 07/24/23
In: 9:45
Out: 10: 01
GARY TEAM
Commodity Units Rate 11 SELFHAUL REFUSE .26
[Gross(In): 7,920. lbs Scl#5
115 . 00 per TON
Tare 7.400. lbs Scl#5
IN' force
roxxxxxnxx~~ Entrv teilixl: C,1
90. ~I.
:0:02: I
APPi-(ooe ~3
Truck :
Container :
Route:
Origin:
00 00 VISA
01611 Total: $
016 E~ 07124123
Net:
In\ t IQ!l\U33
hrvd: Orilir,? Extended
Charge
90.00
520 . lbs]
PAI D CREDIT CARD 90.00
GREG
Escondido Resource Recovery
1021 W Mission Ave
Escondido. CA 92025
(760) 745 -3203
Customer: 0000 Ticket : 33513
Date: 03/19/23
In: 12:39
Out: 13:03
GARY TEAM
Commodity Units Rate 11 SELFHAUL REFUSE .36
[Gross(In): 8.420. lbs Scl#5 98.00 per TON
Ta re 7.700. lbs Scl#5
Driver
tr'
IN
Force
Truck:
Container:
Route:
Origi n:
0000 ~o xnxnroxxxJ J,JQ
08611 ~l~
086 Ca Total: $
®19123
E> ll\\l U: llffi»i1 Cr ,ctr-ge' n.. ,, __
75.00
Net: 720. lbs]
lntr'I tetwl: C,
,~.0
~./IA . ,,0'1
fffl' tooe ~12
PAID CREDIT CARD 75 .00
GREG Driver
MOOOYS
3210.-0&'.fAN§OE BLVD
BONSALL, CA. 92003
760-631-0342
SALE
REF#: 00000011
Batch #: 634
09/12/23
APPR CODE: 003400
ENCRYPTED BY ELAVON
Trace: 11
VISA
............ 9958
OUNT AM
SU RCHARGE
LOAD COUNT
1 2
# LOADS
SIGNATURE
09:53:44
Chip
$20.00
$0.80
3
X
4
MOODY'S
lAZON RECLAMATION
PO BOX 969
)NSALL, CA 92003
-33 16 • FAX (760) 433-6691
DATE
COMMERCIAL RESIDENCE TIME
BOBTAIL 110-WHEEL
1
END DUMP r & T
MATERIAL
5 6 7 8 9
PRICE OTHER CHARGES
$
TOTAL
10
All bills due upon presentation unless otherwise
arranged in advance. Open accounts subject to
1 1/2% month, charge after 30 days unpaid
balance.
TRUCK#
MOODY'S is not responsible for damage to
vehicle while being loaded or unloaded in
yard.
JOB COPY 334tl46