HomeMy WebLinkAboutBrian Shen C&D 2629 Rising Star Dr.pdfCity of Diamond Bar
DIAMOND 13pAR
Construction &Demolition (C&D) Debris Plan
Required for all covered projects, 1,000 sq. ft or more. The deposit shall be returned, to the applicant, without
interest, in total or proportion upon submittal of proof 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@diamondbarea.gov
Complete before obtaining a building, combination or demolition permit
Submit this farm and your deposit to the Building and Safety Division located at: 21810 Copley Dr. Diamond Bar, CA. 91765
Applicant Contact Information:
Name Brian Shen Title owner
Company
Address 2629 Rising Star Drl
city Diamond Bar state CA zip 91765
Phone 626-215-9161 Email brianshen2000@gmaii.com
Project Information: Indicate
Waste Hauler for
❑ Vallev Vista
❑✓ WM ❑ Self Haul
Permit No.
Project Address 2629 Rising Star Dr., Diamond Bar, CA
zip91765
Project Type: JP New Consiniction ❑ flddition/flIteration ❑
Demolition
Building Type: ❑ Commercial a Residential
Estimated Square Feet 1000
TO BE FILLED OUT BY CITY STAFF
Estimated Start Date 03 101 /2022
"C&D Deposit" Paid $
Estimated Completion Date 09 /01 /2022
Staff Initials Date Paid
Fill out the table with estimated quantities in tons for each material that will be generated by your project. Note: A + B = C
Material Type
A B
Estimated Salvage,; Estimated
C
Estimated Total
Applicant Self
Haul (check)
Certified Recycling
Facility or
Reuse or Recycle : Disposal (Trash)
Debris Quantity
Disposal Destination
Asphalt & Concrete
0.00
Brick / Masonry / Tile
0.00
Cabinets, Doors, Fixtures,
�'a0
El
(circle all that apply)
Cardboard
0.00
Carpet, Padding / Foam
0,00
Ceiling Tile (acoustic)
0.00
Dirt
0.00
Drywall
0.00
Landscape Debris
0.00
Mixed C&D Debris
0.40 :0.40
0.80
Li
Mixed Inerts
0.00
Li
Roofing Materials
0.00
Scrap Metal
0.00
Stucco
0.00
Unpainted Wood & Pallets
0.00
Garbage / Trash
0.00
Other:
0.00
TOTAL
0.40 ; 0.40
0.80
To estimate Recycling Rate: (Total A/Total C) x 100 = Recycling % 0.00%
pplicant Name: Brian Shen I Signature: _ Date: { ! 6 Z
CL�L
For information on construction and demolition waste management plans contact the City of Diamond Bar
Environmental Services at 909.839.7015 or via email to greendb@diamondbarca.gov
- 1 - 09/28/17