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Home My WebLink About2342 LONGFELLOW RD; ; CBR2022-1645; Recycle• C cityof Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Development Services Building Division 1635 Faraday Avenue 442-339-2719 www. car/sbadca. gov APPLICABLE TO NEW CONSTRUCTION, ALL RESIDENTIAL ADDITIONS AND ALTERATIONS AND COMMERCIAL ADDITIONS AND ALTERATIONS OVER $200K. If you have questions about the recycling requirement or completing this form, please contact Republic Services at (760) 332-6464 a certified C&D recycler, or the Carlsbad Building Division at (442) 339-2700. Please note: Unless you are self-hauling, Republic Services 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 NoC/5R2QJ,2 ~ /(p<{~ ProjectTitle /Z~q f k../ filll£/'loWI TL /Z<;__ 5 fl. \Ml)./J~ ( ProjectAddress2.'342-. ~tvf{rLl.v{JJ Rd. C'&l) r7JLDuR APN 2/2-l'-C'l ~ q2 -00 -Owner Contractor Architect Other Applicant Name "-../</ tJ N CL.,45~AI □ f\71 □ □ Last First W Applicant Address 's7 (2, ✓ <i.,ny /Jt {! //{)_~5/1A/J ✓C,.d J 92010 Phone "vbO ) 7/t;"J7]'i0 E-mail Address ,J i).,C., ~/ ( @ OUT LootL. , C<,/Vl Applicant Mailing Address ~s-;-<--<.,;A:,..:CJN\,--'--'-,,:: ___________________________ _ (if different than project address) Project Type Re~a1 (check all that apply): Commercial □ Public Building □ Brief Description /2'i.5! (){NI/AL 12.<;;-UuNL Project Size 2 R UJ 5 £ E:mated Cost of Project $_,/fc)'--""'_..(}-1-=•U:....::<IJ'-"'-_~_v ________ _ I (square footage) Please check the appropriate box: I plan on using REPUBLIC SERVICES roll-off bin(s) for all materials and will provide all receipts after construction. 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 sepa rating 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 informati , d that the i rmation is true and correct to the best of my knowledge and belief. PrintNam'0'Ji/N {3!.4~{,U Page 1 of 3 Rev. 05122 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. ----------~-Project Title ess 2-3'·{l LvNG8LlOW RJ. °!L0o2 APN me Su t(}J f2 LA ,s1J Phone 76 0 =-=---'-.J..-+-=-_L.___1____."'--"'::_---I 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 r eport. Goal: the diversion rate shall be 65% by weights of debris. A B C Material Type Estimated Place a (0) check Place a (0) check next Place a (O) check next Waste Quantity next to items to be to items to be to items to be (tons) reused or salvaged recycled disposed at landfill Complete this line of the toble only if only using WASTE MANAGEMENT roll-off bins. Mixed C&D Debris □ □ □ Asphalt & Concrete /J O-lu l..~5 @ □ 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) c; J..)0 l-13$ 12] Landscape Debris (brush, trees, □ □ □ stumps, etc.) No dirt. Unpainted Wood & Pallets □ □ □ Roofing Materials □ □ □ Scrap Metal □ □ □ Stucco 2 000 ~5 ~ Other: □ □ □ TOTAL SECTION C To m eet 65% Diversion Requirement (est' _/ JJ---L...-o_u_\J_x o.6s =___._I_._I.,,........_ ?_()) ___ tons Contractor/Owner Signature Total Esrnedyaste from above . (_;;:/~ Date Minimum Re uired Diversion Page 2 of4 Rev. 05122 .. Conversion Table for Common Construction Waste This document is informational onlv. It is here to helo vou convert truckload auantities to tons if necessarv. Column A Column B Column C Category Material Volume Tons[Unit Tons Mixed Debris Construction ·4it1(J cy X 0.18 = /,J Demolition ~o cy X 1.19 = q7 . ~ Asphalt/Concrete Asphalt (broken) cy X 0.70 = Concrete (broken) ·z.. cy X 1.20 = 'J-,4 Concrete (solid slab) cy X 1.30 = Brick/Masonry/Tile Brick (broken) cy X 0.70 = Brick (whole, palletized) cy X 1.51 = Masonry brick (broken) cy X 0.60 = Tile ia sq ft X 0.00175 = o. I◊~ Building Materials (cabinets, doors, windows, etc.) cy X 0.15 = Cardboard (flat) cy X 0.05 = Carpet By sq uare foot sq ft X 0.0005 = By cubic yard cy X 0.30 = Carpet Padding/Foam sq ft X 0.000125 = Ceiling Tiles Whole (palletized) cy X 0.0003 = Loose cy X 0.09 = Drywall (new or used) 1/2" (by square foot) IOJO sq ft X 0.0008 = o, ~ 5/8" (by square foot) ,gaiiJ sq ft X 0.00105 = Demo/used (by cu. yd.) cy X 0.25 = Landscape Debris (brush, trees, etc.) cy X 0.15 = Asphalt Composition Shingles, asphalt Shingle cy X 0.22 = Unpainted Wood/Pallets By board foot bd ft X 0.001375 = By cubic yard cy X 0.15 = Trash/Garbage cy X 0.18 = Other (estimated weight) cy X estimate = cy X estimate = cy X estimate = cy X estimate = Total all =~~2. ,?o.< Page 3 of 3 Rev .. 05122 ( City of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN B-59 Development Services Building Division 1635 Faraday Avenue www.carlsbadca.gov This form shall be completed for all demolitions and new construction, additions, and alterations. The California's Green Building t andards Code (CALGreen) requires that at least 65% of construction site debris generated during demo Ii Ion projects, most new construction, as well as the majority of building additions or alterations be recy led, reused, or otherwise diverted from landfill disposal. STEP 1: The Applicant must sub It PART 1 of t his form before a building permit application is approved. STEP 2: The permit holder shall utilize a waste management company that can provide verifiable documentation that meets 65 waste diversion. Republic Services is the exclusive franchised waste hauler in the City of Carlsbad. • Option A-Roll-Off Bins Call Customer Service (760) 332-6464 and ask for a C&D account for waste diversion. Republic Serv ces will provide roll-off bins for construction waste. • Option B -Self Haul to epublic Services or other dump site that can provide verifiable documentation. It must be a Certified Source Separated Recycling Facility. When you enter the site, explain to gate operate that this is C&D material. When you exit the site, request a receipt and certificate from gate op rater for waste diversion. STEP 3: Prior to permit close-ou (permit final), the permit holder shall complete PART 2 of this form and submit al l trash and recycling eight receipts to the building inspector. Waste log, acknowledgement, and tickets must be submitted tor lease your certificate of occupancy. C&D CERTIFICATION: ~ I certify under penalty o perjury under the laws of the State of California that the information provided in and with thi 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 t rue and orrect to the best of my knowledge and belief. I understand the waste iversion requirements of the State of California and su bmit this Construction Waste Management Pia pursuant to California Green Building Standards Code 4.408.2 or 5.408.1.1. Failure to provide docu entation of C&IJ reporting, reporting of waste diversion less than 65%, and failure to provide adeq ate weight receipts, may result in enforcement action against me or other responsible parties, incl ding a notice of violation, citat ions, and any other remedies provided in Chapters 1.08 and 1.10 f the Carlsbad Municipal Code. Projects are required to submit their Waste Log, Acknowledgement orm, and Weight Receipts prior to Certificate of Occupancy (CO) issuance. This project does not in olve disposal of universal or hazardous waste OR this project includes disposal of universal or hazardo s waste in a responsible, safe and verifiable manner. Disposal of asbestos- containing materials, ba teries, electronic waste, fl uorescent bulbs, lead based paints, mercury co • • d r frigerants, require special processing prior to commencement of Date: 0 /~/ I~ r / Page 1 of 4 rev 4/24 PART 2. Complete and submit this for before final inspection. Projects are required to submit their Waste Log, Acknowledgement Form, and We ght Receipts prior to Certificate of Occupancy (CO) issuance. Failure to provide documentation, reporting of \laste diversion less than 65%, and failure to provide adequate weight receipts, may render the Project non-ompliant and the responsible parties subject to code enforcement . SECTION A .....,.._."'--''-=~'"'""'-'--LZL---'""---Proj ect Tit I e Project Address,_..,----"--'---'--'----""-"LLIL+-'--!-"-----::.....::J'-"--lg_cR_. ________ APN Applicant Name_~-r'-'~ ........ ~-+-.....;;;._;:~-~.;;...... ______ Phone? /p'Q J l t;°' :J '} ?JO Last First Use this Final Log below to track loads of materials as they leave the job site. @®SAVE RECEIPTS ®® Indicate FINAL quantities in tons for eac material and save receipts and documents from facilities where material is taken. Additional Project Log pages ar e available if necessary. Use City Conversion Table to convert volume to tons. A B C Date Example: 01/01/2020 Material Type Concrete (broken) ®TOTAL Diversion Rate Achieved Actual Amt Reused or Salvaged ' re. Attach the following documentation othis Report: • Original recycling weight tickets, landflll w ght tickets Actual Amt Recycled S tons Actual Amt Disposed in Landfill 7 Destination Facility {Name, Address, Phone) Palomar Transfer Station, 5960 El Camino Real -{760) 603-0153 P,f2. =r7 % ~ 65% Total of columns A+ B + C DIVERSION Return completed form and documentation to: City of Carlsb:id • Original donation receipts with photos and or itemized descriptions Building Division (1st Floor) 1635 Faraday Avenue Carlsbad, CA 92008 • Any other relevant information to support ecycling Report I certify under penalty of perjury und r the laws of the State of California that t he information provided in and with this form pertains to construction an demolition debris generated only from the project listed in PART 1, that I have reviewed the accuracy o informa ion, a that the information is true and correct to the best of my knowledge ::,::':: 1 s1gnatu,e ____ ,, ------Date 6 kc /zv21 J Page 3 of 4 rev 4/24 - Escondido Resource Recovery 1021 W Mission Ave Escondido. CA 92025 (760) 745 -3203 ' I I l ' . . t ( _, 1,'V ' ~ :· __ ''.( / • i INVOICE Customer: 0000 Ticket: 32048 Date: 09/09/23 In: 12:20 Truck: 0000 Out: 12:39 Conta i ner : FRANK H Commodity Units 11 SELFHAUL REFUSE 1.89 [Gross(In): i7. 840. lbs Scl#5 VINCE -------~,it~\- Rate 115. 00 per TON Tare i4.060. lbs Scl#S Route: 0801 1 Origin: 080 San Ma rco Extended Charge 217.35 Net: 3,780. lbs] PAID CREDIT CARD 217.35 Un ver Escondido Resource Recovery 1021 W Mission Ave Escondido. CA 92025 (760) 745 -3203 r L 0 /ty rf'e /( ow-rd INVOICE Customer: 0000 Ticket : 44009 Date: 09/29/23 In: 14:46 Truck: 0000 Out: 15:08 Contai ner: FRANK HOLTS Commodity Units 11 SELFHAUL REFUSE 1.09 [Gross(In): 16.580 . lbs Scl#S VINCE Rate 115. 00 per TON T---IA Aon ,~_ r_,i r 1ar·e 4,4 u . 1u~ ~Liff~ Route: 01611 Origin: 016 Escondido Extended Charge 125.35 l l-.L r\ .,nr\ 1 L_, m:!L-: ClOU. IU::iJ PAID CREDIT CARD 125.35 Driver i ... ---• r --~ [ __ o vz:; :f t_scond i do Resource Recovery 10?1 w Mission Ave Lscondido . CA 92025 ( /60) /~5 -3203 INVOf CL CusLoncr : 0000 Ticket: 67264 Date: ll /09/23 In: 7:39 Truck: 0000 Out: 7:49 Container : FRANK 11 Co~modily Units Rate 11 S! I i 11/\LJI REF USE 1. 56 115. 00 per TON rr~nrrfln\. -~ 7no 1hr C"l~C T ~-ft 13 ~gn 1~-r-1flr It.. V,)..)\11 1/. -V,/U . 1u.::, ..JI...I TTJ IOlt:' l .Ju. ru::i ..)l11t::J Route: 01611 Origin : 016 Escondido Extended Charge 179 . 40 ~1-.L 3 '"" le._, lllel,. 'lcU. U'.::>J i_,CY 7 -/ e O CJ tl(;PA;,° CREDI T C/\Rll l/9 . 110 tl<rG Driver Escond ido Resource Recovery lC~l W Mission Ave f , '-::ondi do. CA 92025 ~ '\60) 74 5-3203 C~<;tomer: 0000 Ticket: 93388 Date: 12/27 /23 FRANK H Commod i t y Units Rate INVOICE In: 16:00 Truck: 0000 Out: 16:15 Container: Route: 07111 Origin : 071 De l Mar 11 SELrl 1/\UL REFUSE 1.14 [Gross(In): 15.060. l bs Sci#S 115 . 00 per TON Ta re 12.780. 7bs Sc1#5 Ext cnacd Charge 131 . 10 Net: 2.280. 1b s7 PAID CREDIT C/\1<0 131. I O 'GRl:G Dr1ver , :. , J