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HomeMy WebLinkAbout1355 BUENA VISTA WAY; ; CBR2022-2074; Recycle(city of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Deve/i;pmefl_t S_erv_i.c~s Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov Applicable to ALL NEW CONSTRUCTION, MAJOR DEMOLITION, ADDITIONS AND ALTER AT IONS . 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 ~ r:::ln:=:::::::::::9'1Mftj\l!'fl81imn, Permit Nn!e; P•rmils will 98\ be iss11•d Applicant Information Permit No. C.BR. zoz 2..-za 74 Project Title OwNE.R-e,u I Lbc.R... ROOM Ab1>1no N Project Address I 3 '? 5 B U J;. t-JA V I S. TA WA'( APN AppllcantName !5E...R...i-J,A-R D s (.)t:__ rx·j Coor □ct □ ------ Last First Applicant Address i 3 ? 5 '.BUt-N A \) I s T~ WAl-( -Cw sk"'-'., Ch 4 2 ooR Phone ( 7bo} Zlz ~az3-, E-mail Address SliSANr1"J ~~'-"·-==C'-"4"-'M=-------- Applicant Mailing Address (if different than project address) Project Type (check all that apply): Residential [R] Commerclal □ Public Building □ Brief Description :e.NrS.'r'. -t I VI NC-r R OD"i. J;..)'D ¢Lt),.i.'N.,.___ ___________ _ Project Size 3 50 lP Estimated Cost of Project $.i.b_5,,.__a=---o'--'cl"'----------- (square footage) Please check the appropriate box: DI plan on using WASTE MANAGEMEN: roll-off bin(s) for all materials and will provide all receipts after construction. ~ I plan on self-hauling to a certified recycling facility and wlll provide all receipts after construction. D This is a proposed LEED certified project and I plan on separating materials on site in conjunction with WASTE MANAGEMENT. 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 St)E... P€:{2f,IAfZ P Signature ~Af-L-'-"--..::-_-_-_-_ -_ -_::::._.__ ___ Date Page 1 of 4 Rev. 04122 PART 1 (cont'd) Complete, obtain signature, and submit this form when applying for a Building Permit. Note: Permits will not be issued without a completed Construction Waste Management Plan. DEBRIS RECYCLING ESTIMATE: • • Permit No. C. BR. :to 2-'l -"Lo 74 Project Title awne.v ,~ }~ )l..O'UJ:l::'.I, ~11D~ Project Address 1355 ~e.-ry... V rs·..Ja 'l/i/% -C8(), c>,A. qJ.oo~ APN I Applicant Name~~---~~~e,..~ _______ Phone 7<:,o 2-l z_, ~ 8 3 7 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. Goal: the diversion rate shall be 65% by weights of debris. Materlal Type Complete this line of the table only if only vsing WASTE MANAGEMENT roll-off bins. Mixed C&D Debris Parking lot Asphalt & Concrete Brick/ Masonry/ Tile Mixed Inert Debris Cabinets, Doors, Fixtures, Windows (circle all that apply) Carpet 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: TOTAL - Estimated Waste Quantity (tons) To meet 65% Diversion Requirement (estimate) Contractor/Owner Signature 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 / (p fo n 5 x 0.65 = __________ tons Minimum Required Diversion Page 2 of 4 Rev. 04122 DEBRIS RECYCLING REPORT {ACTUAL): 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. Address C J3 R <-D '2-'L -7-o 1 ~ Print Name S u E... B E. /2.. tJ A R.. D _1 _3_0.c._'5_-'-f:?:0..c....e...'-'€'-.,_,:..,___.V'-','-·:s.,_~'---'----'-w--=--~-'----=--f---C=8-=-,D,-9-'---Z.-o_o-=-~--Date -"3d -;;2. Lf 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. Date Material Type A B C Actual Amt Reused or Salvaged Actual Amt Recycled Actual Amt Disposed In Landflll Destination Facllity (Name, Address, Phone) Example; 01/01/2020 Concrete {broken) 5 tons Palomar Transfer Station, 5960 El Camino Real -(760) 603-0153 -e-Moot> y • s r EL Co z_otv ©TOTAL , :> l_ i-D rJS J 3 l-h:> ns-= I 0(:) % --------------Diversion Rate Achieved Contra<to,/Owne, Slgna'""'7"al of ~ ..... --r.-ot-al-of column~Aa:: + c 1/ ;:i;: ~ Attach the following documentation-to this Report: Return completed form and documentation to: • Original recycling weight tickets, landfill weight tickets City of Carlsbad • Original donation receipts with photos and/or itemized descriptions Building Division (1st Floor) • Any other relevant information to support Recycling Report 1635 Faraday Avenue Carlsbad, CA 92008 Page 3 of4 Rev. 04/22 Bart Dixon's boboGI Services Inc 936 Sunset Dr. Vista Ca. 92081 Office 760-726-3262 fax 760-630-3568 Mobile 760-212-8527 /' Q -~ ,. /) ·- NAME c'~( ]( -L ) (:-IJ 'fliq_,,1 O<.. ADDRESS [~I u'~A 1/M. ... CITY f 1 ,r-/<. L ,,,.,,;f PHONE rt:"' /I J..Jl"I ,, ....,..;;:-.,<'"""\-, DESCRIPTION OF WORK rteV.:::J ,r, T7./.J d-<....,/C7...::) _("\ A l /I /I /C.evitOl/€-~ Jttkl('c' fl' NIJe... t ! WO ,,f_ _ I "·.J I."""\ A - /-4:J&t,,t;~ ~ A. --...,-,LI',-'<., ..... oJ-f?.. XL..tP L < &,,If /'"I .. /'l /) (~dlt0_ 1-o.r ( dY7.rA°.~ L QTY. A I ~TERIAL UNITS I /11nd u ,?/ j / _/lp -l"' toNS t /. -··1 -I l"""'~/P 0-/'z,eg~ / ,JI .,rl-" Uo -t-rJ ,v<;, I - MISCELLANEOUS CHARGES ,, LABOR/ RENTAL TIME HOURS RATE V I\ I 1 V"'\M") ;er IUCU/} -L ,.._.. INVOICE NUMBER DATE ORDERED TOTAL LABOR TOTAL MATERIAL DATE STARTED DATE FINISHED TOTALMISC. SUBTOTAL CUST. SIGNATURE AUTH. SIGNATURE TAX GRANDTOTAL AMOUNT -:::))3 ,S J =- ,.,.e>_ /SO! ! I AMOUNT ~ ~ ~ ! l I i ! . r-Jf-J) 4 :''.?S-! I ,w:, \ -..J.~:-z: r ., :,a_. ,