HomeMy WebLinkAboutWaiver Application- Colima Endoscopy Center.pdfClty Manager's Office
Attn: Tara Reyes
21810 Copley Drive
Diamond Bar, CA. 91765
(909) 839-7015
greendb@diamondbarca.gov
S8 1383 ORGANICS RECYCLING REGULATIONS
WAIVER REQUEST FORM
D THIRD-PARTY WAIVER (if you have a landscape contractor and/or other organics recycler)
Pleasa provide the following information to request a Third-Party Recycling Waiver.
• Third-party organic waste recycling service information:
> Recycler(s):1) Business Lic #: Self-Haul Permit #: Phone: _
2) Business Lic #: Self-Haul Permit #: Phone: _
> Material type(s): Est. recycled per week: __gallons OR cubic yards
> Faci/it(ies) where this material is taken for recycling
[l] WAIVER FOR BUSINESSESIPROPERTIES WITH MINIMAL ORGANIC WASTE (De Minimis Waiver)
Please provide the following information to request a low-waste generator "de minimis· waiver.
• Average number of employees onsite: 6 (Tu,Th,F)
• Does your business have a cafeteria providing meals to employees? _N_O _
• Estimated number of employees that eat meals/snacks onsile: 3 (Tu,Th,F)
• Contracted landscaper service information:
> Landscaper name: Business License #: _
Self-Haul Permit #: Phone: _
• Average amount of organic waste collected per week: o ;" 2 cubic yards of waste and < 20 gallons of organics o < 2 cubic yards of waste and < 10 gallons of organics
D SPACE CONSTRAINT WAIVER
Please provide the following information to request a Space Constraint Waiver.
• I have documentation that soace constraints preclude placement of green waste andlor food waste recycling
containers at my business, No (Please attach documentation)
• I heve worked with the City to determine that we cannot adjust container sizes or make other such changes to
resolve the space constraint issue. -,-N",o,,-_
• Please indicate the specific program(s) you are requesting a waiver for.
Green waste recycling onlyD Food waste recycling onlyD Green waste & food waste D
Date
10-9+-2024
horized Business Representative
that you have a full understanding of your business'/property's obligations to provide information,
te with the City, as detailed in the instructions herein which accompany this form.
By signing this form, you are attest!
report to, and otherwise fully co
Hye Kim, Manager