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Home My WebLink About2820 ROOSEVELT ST; ; CBC2024-0022; Recycle( 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 Standards Code (CALGreen) requires that at least 65% of construction site debris generated during demolition projects, most new construction, as well as the majority of building additions or alterations be recycled, reused, or otherwise diverted from landfill disposal. STEP 1: The Applicant must submit PART 1 of this 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 Services will provide roll-off bins for construction waste. • Option B -Self Haul to Republic 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 operator that this is C&D material. When you exit the site, request a receipt and certificate from gate operator for waste diversion. STEP 3: Prior to permit close-out (permit final), the permit holder shall complete PART 2 of this form and submit all trash and recycling weight receipts to the building inspector. Waste log, acknowledgement, and tickets must be submitted to release your certificate of occupancy. C&D CERTIFICATION: ~ 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. I understand the waste diversion requirements of the State of California and submit this Construction Waste Management Plan pursuant to California Green Building Standards Code 4.408.2 or 5.408.1.1. Failure to provide documentation of C&D reporting, reporting of waste diversion less than 65%, and failure to provide adequate weight receipts, may result in enforcement action against me or other responsible parties, including a notice of violation, citations, and any other remedies provided in Chapters 1.08 and 1.10 of the Carlsbad Municipal Code. Projects are required to submit their Waste Log, Acknowledgement Form, and Weight Receipts prior to Certificate of Occupancy (CO) issuance. This project does not involve disposal of universal or hazardous waste OR this project includes disposal of universal or hazardous waste in a responsible, safe and verifiable manner. Disposal of asbestos- containing materials, batteries, electronic waste, fluorescent bulbs, lead based paints, mercury containing equipment and refrigerants, require special processing prior to commencement of construction or demolition activities. LuLk)W~ Date:_5_1_16_1_20_2_4 _____ _ Signature of Applicant Page 1 of 4 rev 4/24 PART 2. Complete and submit this form before final inspection. Projects are required to submit their Waste Log, Acknowledgement Form, and Weight Receipts prior to Certificate of Occupancy (CO) issuance. Failure to provide documentation, reporting of waste diversion less than 65%, and failure to provide adequate weight receipts, may render the Project non-compliant and the responsible parties subject to code enforcement. SECTION A Permit No. C)3l W"ZJ.1 -{J{n7.,., Project Address '2ftlQ ~Vt If: S.J-. Applicant Name Nl£M1tn w h Last First Project Title APN Phone lQ rvt . tittJ • ct05 2 Use this Final Log below to track loads of materials as they leave the job site. ®®SAVE RECEIPTS®® Indicate FINAL quantities in 12.!ll 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 Date Example: 01/01/2020 1/10 1//u}2..J Material Type Concrete (braken) ~TOTAL Actual Amt Reused or Salvaged Actual Amt Actual Amt Recycled Disposed in Landfill 5 tons Destination Facility (Name, Address, Phone) Palomar Transfer Station, 5960 El Diversion Rate Achieved _I lf_. _7 _,l_/4____,;_. c:; __ = I 00 % ~65% Total of columns A + B Total of columns A + B + C DIVERSION 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) 1635 Faraday Avenue Carlsbad, CA 92008 • Any other relevant information to support Recycling Report 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. Applicant Signature_( P ............... C!k~t&-----1NI--YlNVl~A4:-------Date -~-"<-+-L-/ll1----"-l,,--,"t ~"--------fLt-- Page3of4 rev 4/24 MOODY'S EL CORAZON RECLAMATION C~1M PO BOX969 BONSALL, CA 92003 (760) 433-3316 • FAX (760) 433-6691 P. JOBII DATE CASH CHECK CHARGE COMMERCIAL RESIDENCE TIME NAM • ~TY 1:51= i:5RIGIN JOB LOCATION PU FLATBED T&T LOAD COUNT 1 2 3 4 5 6 7 8 9 10 I I I # LOADS X PRICE OTHER CHARGES $ TOTAL SIGNATURE All bills due upon presentation unless olheiwise arranged in advance. Open accounts subjec1 to 1 1/2% month, charge after 30 days unpaid balance. TRUCK# MOODY'S is not responsible for damage to vehicle whije being loaded or unloaded in yard. JOB COPY 346189 MOODY'S C )11---> EL CORAZON RECLAMATION PO BOX 969 BONSALL, CA 92003 (760) 433-3316 • FAX (760) 433-6691 P.O. JOB# DATE CASH CHECK CHARGE COMMERCIAL RESIDENCE NAME CITY OF ORIGIN JOB LOCATION PU FLATBED 10-WHEEL END DUMP T&T LOAD COUNT 1 2 3 4 7 8 9 10 #LOADS X PRICE OTHER CHARGES $ TOTAL SIGNATURE 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 34n 7 P .. CASH CHECK NAME OTYOF0RIGIN JOB LOCATION PU TRAILER LOAD COUNT 1 2 #LOADS MOODY'S EL CORAZON RECLAMATION POBOX969 BONSALL, CA 92003 (760) 433-3316 • FAX (760) 433-6691 DATE CHARGE COMMERCIAL RESIDENCE TIME • FLATBED BOBTAIL END DUMP T & T 3 4 5 6 7 8 9 X PRICE OTHER CHARGES $ TOTAL L 10 SIGNATURE 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 346122 P.O CASH CHECK NAME CITY OF ORIGIN JOB LOCATION PU rR~ LOAD COUNT 1 2 ~ # LOADS SIGNATURE MOODY'S EL CORAZON RECLAMATION PO BOX 969 BONSALL, CA 92003 (760) 433-3316 • FAX (760) 433-6691 JOB# DATE CHARGE COMMERCIAL RESIDENCE TIME IFLATBE~ BOBTAIL 110-WHEEL 1 END DUMP r & T MATERIAL en nr re_ +-e 3 4 5 6 7 8 9 X PRICE OTHER CHARGES $ TOTAL 10 All bills due upon presentation unless otherwise arranged In advance. Open accounts subject to 1 1 /2% month, charge aft.er 30 days unpaid balance. TRUCK# MOODY'S is not responsible for damage to vehicle while being loaded or unloaded in yard. JOB COPY 346221