PUBLIC WORKS DEPARTMENT Resource Recovery & Recycling Division CONSTRUCTION & DEMOLITION (C&D) WASTE MANAGEMENT PLAN

Transcription

1 PUBLIC WORKS DEPARTMENT Resurce Recvery & Recycling Divisin CONSTRUCTION & DEMOLITION (C&D) WASTE MANAGEMENT PLAN Plan Check #: 1. GENERAL PROJECT INFORMATION: Over-the-Cunter Permit Yes N City-Spnsred Prject* Yes N *Name f City Emplyee cntact: Type f Prject: Demlitin* New Cnstructin Alteratin Additin Prject Descriptin (In Detail) Prject Address: Prject Sq. Ft.: Prject Valuatin: Estimated Prject: Start Date: Cmpletin Date: Legal Owner (please print): Phne N. Applicant s name (please print) Phne N.: Fax N.: Applicant s Relatin t Prject: Owner Cntractr Architect Permit Expeditr Cmpany Name (if Applicable): Address: *please nte: fr all demlitin nly prjects, this frm must be cmpleted by cntractr r wner nly. ====================================================================================================== (fr Staff nly) Permit#: Waste Management Plan (WMP) Reviewed By: Date: WMP Apprved: Yes N If nt apprved, describe reviewer's actins: Rev

2 Address: 2. STRATEGIES FOR WASTE RECYCLING AND/OR DISPOSAL: Fr each f the fllwing categries f recycling and dispsal activities, describe thse strategies yu plan t utilize fr the prject at the address abve. 1. SALVAGE: Yes N 1a D yu plan t salvage materials frm this prject prir t cnstructin r demlitin activities? 1b If "yes," please list the items that will be salvaged (e.g., drs, windws, jambs, casing, tilets, sinks, ther fixtures, hardwds, wd siding, cabinets and shelving, carpet and pad, bricks, acustical ceiling, lights, fans, ceramic rf tiles, structural materials, reusable lumber, etc.)? Must take befre and after pht dcumentatin and/r sales/dnatin receipts required. * Befre pictures will represent befre prject is started 2. SOURCE SEPERATION:* Yes N 2a. D yu plan t surce separate any materials n this prject fr delivery t a recycling facility (e.g., separatin f items such as wd, cncrete, metal int separate bins)? This wuld als include materials that will be recycled at a landfill as daily cver r as landfill rad base, Receipts frm apprved facility are required. 2b. If yu plan t salvage r surce separate, please indicate the materials, haulers, and facilities. Receipts will be required. (We d nt have an auditing prcess fr reuse prgrams ex: habitat fr humanity r reuse facilities, r Mexic) Materials Hauler Facility 3. ON-SITE USE: Yes N 3a D yu plan any n-site reuse activities fr this prject (e.g., reuse f wd frms frm ther prjects fr cncrete, n-site crushing f cncrete fr n-site use, use f reusable cntainers r pallets fr material deliveries, etc.)? (please prvide phts f lcatins these items were reused) If "yes," please describe. 4. INERT Fill USE: Yes N 4a Will any surce separated dirt r mixed inerts (i.e., dirt, cncrete, asphalt) be delivered t a City f Santa Mnica apprved inert landfill (ne that accepts nly inert material) r be used fr any ther nn-landfill fill purpse? (Fr Cncrete and Asphalt: lad receipts will be required) (Dirt: prvide phtgraphic dcumentatin if lad tickets are nt available by the facility & written dcumentatin frm facility wner that material were dumped at their site.) 4b If "yes," please indicate the materials, haulers, and facilities. Materials Hauler Facility *This includes recvering reusable items frm remdeling r demlitin prjects and includes stand-alne items (appliances), easy t remve items such as drs, mantelpieces, and remval f reusable structural items by hand (lumber, wd siding, rf tiles).

3 Address: 5. RECYCLABLES: Mixed C&D recycling facilities and diversin rate: Yes N 5a Will any mixed debris be delivered t a mixed C&D recycling facility fr mechanical and/r manual separatin f recyclables? (See C&D General Instructin fr receipt requirement) 5b If "yes," identify the Facility (check ne) X Hauler facility and hauler wh will deliver. Reclgy - 83% Suthern Califrnia Dispsal 82% East Valley Diversin 85% Dwntwn Diversin 83% Califrnia Waste Serv. 87% Cnstructin Demlitin Recycling Inc.(IRS) 78% Direct Dispsal 73% 6. SELF-HAUL: Yes N 6a Will any C&D debris be self-hauled by yur cmpany r by subcntractrs? 6b If "yes," identify which cmpanies will be self-hauling debris. List Names f hauler and prvide RRR apprved facility. (refer t definitin f self-haul in the C&D Waste Management Plan Instructins/General Infrmatin. Self-Hauler Facility 7. REFUSE: Dispsal at Landfill Yes N 7a Will any materials frm this prject be dispsed f at a landfill? 7b If "yes," identify the haulers wh will deliver the dispsed debris and the dispsal facilities. Landfill Facility 7c D yu have any exemptins t request prir t start f the prject (Yes/N) If Yes: What type f material : 8 EDUCATIONAL STRATEGIES: Describe in detail hw yu plan t infrm yur wrkers and any subcntractrs f and ensure participatin in yur diversin gals and Waste Management Plan activities.

4 Address: 9. ESTIMATE OF RECYCLING AND/OR DISPOSAL ACTIVITIES`: Summarize the infrmatin prvided in Part Three (pages 2-3) f this Waste Management Plan n the fllwing chart. Please refer t the C&D Cnversin Table (pg. 5) if assistance in calculatin is needed Type f Material Type f Ttal Ttal Ttal Activity Quantities Recycled Dispsed (check bx) (In Tns)* (In Tns)* (In Tns)* Mixed Materials*** Mixed C&D Materials Mixed Inerts Separated Materials Asphalt Brick Cncrete Dirt/Clean Fill Lumber Rfing Materials Metals Sheetrck Yard Trimmings Other Salvageable Materials/Items**** Other Recycle - t Facility Recycle - Salvage** Recycle - On-Site Reuse Dispse - t Facility Facility Used (list specific names f recycling facilities, transfer statins, landfills, etc.) Methd f Transprt (Self Haul, debris bx, ther?) TOTALS: *See Cnversin Table (page 5) t cnvert cubic yards t tns. **Estimate in punds where necessary and cnvert t partial tns -- see Cnversin Table (page 5). ***Divide the "Ttal Quantities" tnnages fr all mixed materials between the "Ttal Recycled" and "Ttal Dispsed" clumns. [Fr example, if the facility yu are using (see C&D Recycling Facilities list) has a 70% diversin rate, and yu are sending 10 tns t that facility, "Ttal Recycled" = 7.0 and "Ttal Dispsed" = 3.0.] ****See #1b n page 2 fr examples f salvageable materials ther than thse items listed under "Separated Materials" abve. Estimated Diversin Rate: %***** *****Divide tns f waste recycled by ttal tns f waste recycled and dispsed; cnvert t a percentage.

5 C&D Cnversin Table Address: Please use this page if needed t calculate yur estimated tnnages Check each cnversin being used. Mixed C&D Materials 1 cubic yard = 500 punds Mixed Inerts 1 cubic yard = 1 tn Asphalt, Brick, Cncrete, Dirt (separated frm 1 cubic yard = 1 tn ther materials) Lumber 1 cubic yard = 150 punds Asphalt Shingles 1 cubic yard = 419 punds Asphalt/Tar Rfing 1 cubic yard = 2,919 punds Wd Shake Shingle Rfing 1 cubic yard = 435 punds Metals 1 cubic yard = 906 punds Sheetrck 1 cubic yard = 394 punds Yard Trimmings 1 cubic yard = 108 punds Other Salvaged Items Salvaged Items Estimated Punds 2000 = Tns Example: Cabinets, drs, windws, tilets, etc. 100 lbs =.05 If yu believe yu have justificatin fr using a different cnversin than abve, please explain belw. FORM SUBMISSION: I hereby attest that the infrmatin prvided n this frm (pp. 1-5) is cmplete and accurate. Any prpsed changes t an apprved Waste Management Plan must be resubmitted and re-apprved by City staff in rder t ensure return f the Perfrmance Security. If the minimum required recycling rate is nt met, the Perfrmance Security refund willbe prrated. Perfrmance Security refund request fr the prject listed belw must be accmpanied by weight tickets fr all debris generated, including all trash, salvage, reuse and recycling, and submitted within 30 days frm cmpletin f (initial and date next t prject type): --Demlitin Final Inspectin Initial Here: Date : --New Cnstructin Initial Here: Date: --Tenant Imprvement Final Inspectin. Initial Here: Date: All materials generated frm this prject must be hauled by an apprved City f Santa Mnica hauler as listed in the Waste Management Plan. Initial Here: Date: All materials generated frm this prject must be hauled t an apprved/certified facility as listed in the Waste Management Plan. Initial Here Date: If ne r all f the abve cnditins are nt met, perfrmance security Perfrmance Security will be frfeited in full. I understand any refund will nly be issued t the riginal payee and it is nntransferable. Initial here Date Rev Applicant's Signature: Date: Applicant (please print):