HomeMy WebLinkAboutDebtis Plan and Weighmaster Certificates.pdfCity of Diamond Bar
DIAMON:�
Construction & Demolition (CAD) Debris Flan
Recluired for all covered projects, 1,000 sq. ft or more. 7hc deposit shall be returrted, to the applicant, without
interest, in total or proportion upon submittal ofproof that no less than 75% of the C&D was diverted.
Use of unauthorized waste haulers may also result in forfeit of the deposits.
Receipts and weight tickets can be submitted to: greendb(a?diamundbnrca.gov
Complete be fibre obtaining a building, combination or demolition permit.
Submit this form and your depoetit to the Building and Safety Division 1wated at; 31810 Copley Dr. Diamond Bar, CA. 91765
Applicant Contact Information:
N Min Liu Title Ms
Company
Address 20949 Northampton St
city Diamond Bar stated zip 91789 ^`
Phone 840-244-5257 Email Iky888Cyahoo- cam
Project Information: Indicate
Waste Hauler for C&D_
Permit No. F - t %4 ❑ Valley Vista
❑ WM 0 Self Haul
Project Address 20949 Northampton St, Diamond Bar
zip91789
Project Type: ❑ New Construction ❑ Add7dWAlteration Q
Demoffdon
Building Type: Q Commercial i9k Residentt'al
Estimated Square Feet 2100
4 -
TO BE FILLED OUT BY CITY STAFF
Estimated Start Date JUIy 115 12024
"C&D Deposit" Paid $ a =o , —
Estimated Completion Date Juiy /25 /2024
S' l iti Staff Initials � Date Paid 7 f S 1 lr
---
Fill out the table with eslirnated quantides in tons for each material that will be generated by your projec,'t. Note: A + B = C
Matcrial Type
A B
fstimaud Salvage,: Estimated
C
f,,stimared Total
applicant Self
Hatt) (check)
Certified Recycling
Facility or
Reuse or Recycle : Disposal (Trash)
Debris Quantity
Disposal Destination
Asphalt & Concrete
000
Brick / Masonry / Tile
0.00
Cabinets, Doors, Fixtures,
0.00
❑
Windows (circle all dat apply)
Cardboard
0.00
Carpet, Padding / Foam
0.00
Ceiling Tile (Emustic)
0.00
Din
0.00
Drywall
0.00Ll
Landscape Debris
T
0,00
l
Mixed C&D Debris
Q_ 00
Li
Mixed Inet7s
0.00
Roofing Materials
; 4,00
4.00
✓
Grand Central Recycling
Scrap Metal
0.00
Stucco
0.00
Unpainted Wood e52 Pallets
0.00
Garbage / Trash
0.00
Other:
0.00
TOTAL
0.00 4.00
4.00
To estz=te Recycling Rate: (Total A/ Total Q x 100 = Recych ng % 0. 00%
Applicant Name: Min Liu Signature: Date: July 5, 2024
For itlfomialion on construction and demolition waste management plans cdntact the City of Diamond Bar
Environmental Services at 909.839.7015 or via cmail to pireendb@diamondbarca.gov
- 1 - 09/28/ 17
WEIGHMASTER CERTIFICATE
THIS IS TO _CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose
signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section
12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of
the California Department of Food and Agriculture.
Weighed at:
GRAND CENTRAL RECYCLING &
TRANSFER STATION INC. CITY OF
INDUSTRY YARD
999 HATCHER AVE
CITY OF INDUSTRY, CA 91748
Customer:
SELF -HAUL
999 HATCHER AVE
CITY OF INDUSTRY, CA 917481016
Customer # : GC-41723
Vehicle ID : SELFHAUL / SELF HAUL-CASH/CREDIT/CHK
License: 76508D2
Comment : JOHN YAN VISA
Or_ [gin
wpgT rnvTNA
Material & Services
BKE
Ticket #:
110474
Date :
7/15/2024
Time In:
9:33:55AM
Time Out:
9:56:05AM
INBOUND LOAD
SYSTEM GENERATED
Gross Tare Net wit Amount
M 8960 LB 2 5640 LB 3320 LB 1.66 TN 166.00
Total Qty: 1.66
Total Due : $166.00
Driver Signature
Payment Information
Credit Card VISA: 0462 Auth: 06604D $166.00
Received by Weighmaster.
LLURY ANEL-MENDOZA
WEIGHMASTER CERTIFICATE
THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose
signature is on this certificate,,who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section
12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of
the California Department of Food and Agriculture.
Weighed at:
GRAND CENTRAL RECYCLING &
TRANSFER STATION INC. CITY OF
INDUSTRY YARD
999 HATCHER AVE
CITY OF INDUSTRY, CA 91748
Customer:
SELF-HAUL
999 HATCHER AVE
CITY OF INDUSTRY, CA 917481016
Customer #: GC-41723
Vehicle ID : SELFHAUL / SELF HAUL-CASH/CREDMCHK
License: 76508D2
Comment: JOHN YAN VISA
Or___ ic�in Material & Services
WEST COVINA BKE
Driver Signature
Received by Weighmaster:
RUBEN NUNEZ
Ticket #:
110646
Date :
7/15/2024
Time In:
11:48:11AM
Time Out:
11:48:11AM
INBOUND LOAD
SYSTEM GENERATED
Gross Tare Net Qty Amount
M 8480 LB M 5640 LB 2840 LB 1.42 TN 142.00
Total Qty: 1.42
Total Due : $142.00
Payment Information
Credit Card VISA: 0462 Auth: 00955D $142.00
WEIGHMASTER CERTIFICATE
THIS IS TO 'CERTIFY that -the following described commodity was weighed, measured, or counted by a weighmaster, whose
signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section
12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of
the California Department of Food and Agriculture.
Weighed at:
GRAND CENTRAL RECYCLING &
TRANSFER STATION INC. CITY OF
INDUSTRY YARD
999 HATCHER AVE
CITY OF INDUSTRY, CA 91748
Customer:
SELF -HAUL
999 HATCHER AVE
CITY OF INDUSTRY, CA 917481016
Customer #: GC-41723
Vehicle ID : SELFHAUL / SELF HAUL-CASH/CREDIT/CHK
License: 76508D3
Comment: JOHN YAN VISA
Origin
WEST COVINA
Material & Services
BKE
Driver Signature
Received by Weighmaster:
RUBEN NUNEZ
Ticket #:
110824
Date :
7/15/2024
Time In:
2:49:30PM
Time Out:
2:49:30PM
INBOUND LOAD
SYSTEM GENERATED
Gross Tare Net Q_ty Amount
M 8400 LB M 5640 LB 2760 LB 1.38 TN 138.00
Total Qty: 1.38
Total Due: $138.00
Payment Information
Credit Card VISA: 0462 Auth: 04419D $138,00