HomeMy WebLinkAbout2839 LOKER AVE; E; CBC2022-0384; Recycle•
(city of
Carlsbad
CONSTRUCTION WASTE
MANAGEMENT PLAN
8-59
Deyelopm~nt Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
APPLICABLE TO NEW CONS RUCTION, RESIDENTIAL ADD ITIONS AND ALTERATIONS OVER $6OK
VALUATION AND COMMERCIAL ADDITIONS AND ALTERATIONS OVER $200K. 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 Republic Services at (760) 332-6464, a certified C&D recycler, or
the Carlsbad Building Division at (442) 339-2719 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
Applicant Information
Permit No. ( 12 ,b ?(. 2; l_ t'J' I I Project Title
Project Address2839 LOKER AVE. E.
Applicant Name BUTLER, SCOTT
5TH AXIS TENANT IMPROVEMENT
APN 209-083-14
Other
last First
[ZJ PROJ. MGR.
ApplicantAddress 7140 ENGINEER RD. SAN DIEGO, CA. 92111
Phone (760 ) 274-7646
Applicant Mailing Address
(if different than project address)
Project Type
(check all that apply):
Residential □
E-mail Address sbutler@5thaxis.com
Commercial
IZ] Public Building □
Brief Description COVER INTERIOR LOADING DOCK AREA. TWO NEW OUTDOOR SECURED STORAGE AREA
Project Size 1 , 999 Estimated Cost of Project $_1_0_2_, 0_0_0 __________ _
(square footage)
[if e ::::: :•,:~:::::::•,:•::RVICES coll-off bin(s) foe all matecials and will p,ovide all ceceipts aftec constc,ction.
D I plan on using a City Approved hauler and will provide all receipts at the final occupancy inspection.
D This is a proposed LEED certified project. 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 .S C...ol\ l> VT\.-£ fl. Signature ~ U Date /0-26-22.
Page 1 of4 Rev. 2.10.21
PART 1 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 :
I . Permit No. Project Title 5TH AXIS TENANT IMPROVEME~
Project Address2 839 LOKER AVE. E. APN 209-083-14
Applicant Name BUTLER, SCOTT Phone 760-27 4 -7646
Last First
-.... ... ~t111•r111,•: 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.
A B C
Material Type Estimated Place a(✓) check Place a(✓) check next Place a ( ✓) 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 table only if
only using WASTE MANAGEMENT
roll-off bins.
Mixed C&D Debris
Parking lot Asphalt & Concrete D
Brick/ Masonry/ Tile
Mixed Inert Debris
Cabinets, Doors, Fixtures,
Windows (circle all that apply)
Carnet
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
Scrao Metal '/2-1oN ✓
Stucco
Other:
TOTAL
-~~--111
To meet 65% Diversion Requirement (estimate) ~ -r;N X 0.65 = tons
Total Estimated Waste from above Minimum Required Diversion
Contractor/Owner Signature J.4-~U Date LD -U-27-
Page 2 of 4 Rev. 7/1i20
PART 2 Complete before final inspection, obtain WASTE MANAGEMENT signature, and return with receipts prior to final
building approval.
DEBRIS RECYCLING REPO RT (ACTUAL):
Acknowledgement
I certify under penalty of perjury under the laws of the State of California that the information provided in and w ith this
form pertains to construction and demolition debris generated only from the project listed in PART 1, that I have
review ed the accuracy of the information, and that t he information is true and correct to the best of my knowledge
and belief.
Permit No.C<3cWZ-Z -o JS~ Print Name
Address 2.03 Cf L-~ Av( f 4~:r
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 facilit ies where material is taken.
Addit ional Project Log pages are available if necessary. Use City Conversion Table to convert volume to tons.
A B C
Date Material Type Actual Amt Actual Amt Actual Amt Destination Facility
Reused or Recycled Disposed in (Name, Address, Phone)
Salvaged Landfill
Exame_le: Palomar Transfer Station, 5960 El
01/05/2018 Concrete (broken) 5 tons Camino Real
-(760) 603-0153
ro-11-(j 0
I l. ... 2J:}. 0 'v
-2-0 0
0 t-{ ~"'S 0
□TOTAL
Diversion Rate Achieved ---------'-----------_____ %
~ 65%
:5 65%
Total of columns A+ B Total of columns A + B + C DIVERSION
Contractor/Owner Signature, .. ~~F"''-=w-f-...,/?,----,---~ ________ Date
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
Rev, 51612022
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