HomeMy WebLinkAboutWaiver Application- Full Line Supply�� MIkelt
DIAMOND BAR
City Manager's Office
Attn: Tara Reyes
21810 Copley Drive
Diamond Bar, CA. 91765
(909)839-7015
gmandb@diamondbarco.gov
SB 1383 ORGANICS RECYCLING REGULATIONS
WAIVER REQUEST FORM
INFORMATIONAPPLICANT
BUSINESS OR MULTIFAMILY COMPLEX NAME BUSINESS LICENSE NUMBER
FULL LINE SUPPLY 1020220000348
BUSINESS OR MULTI -FAMILY PHYSICAL ADDRESS DATE SUBMITTED
20450 YELLOW BRICK ROAD, SUITE 7B, WALNUT, CA 91789 7/l/2022
BUSINESS OFFICE MAILING ADDRESS CITY STATE ZIP
SAME AS ABOVE I WALNUT CA 91789
CONTACT INFORMATION (lordesignafed business representative who should receive waivarrelefed nofices from the City)
Contact Namsaite Phone Number E-Mall
FANNY LIU 909-262-5772 fulllinesupply6@gmail.com
THIRD -PARTY WAIVER (if you have a landscape contractor and/or other organics recycler)
Please provide the following information to request a Third -Party Recycling Waiver..
• Third -party organic waste recycling service information:
D Recycler(s): i) Business Lic #: Self -Haul Permit #: Phone:
2) Business Lic #: Self -Haul Permit #., Phone:
D Material type(s): Estrecydedper week: _ gallons OR cubic yards
D Facifit(ies) where this material Is taken for recycling
❑� WAIVER FOR BUSINESSES)PROPERTIES WITH MINIMAL ORGANIC WASTE (De MLnimis Waiver)
Please provide the following information to request a low -waste generator "de minim/s" waiver:
• Average number of employees onsite:4
• Does your business have a cafeteria providing meals to employees? NO
• Estimated number of employees that eat meals/snacks onsite: NO
• Contracted landscaper service information:
➢ Landscaper name: N/A Business License #:
Self -Haul Permit#: Phone:
• Average amount of organic waste collected per week:
Q a 2 cubic yards of waste and <20 gallons of organics
O< 2 cubic yards of waste and < 10 gallons of organics
SPACE CONSTRAINT WAIVER
Please provide the following information to request a Space Constraint Waives
• I have documentation that soave constraints preclude placement of green waste and/or food waste recycling
containers at my business, No (Please attach documentation)
• I have worked with the City to determine that we cannot adjust container sizes or make other such changes to
resolve the space constraint issue. No
• Please Indicate the specific programs) you are requesting a waiver for:
Green waste recycling only ED Food waste recycling only 0 Green waste 8 food wasleg
By signing this hum, you are atlesting. that you have a full understanding of your buslnesOpmperlys obligations ro provide kilometer.
report to, and otherwise fully cooperate with the Cl �ebmled In the instructions herein which accompany this form.
FANNY LIU / GM
Pored Name, Title and Signature
10/9/2024
Date