HomeMy WebLinkAboutC&D.�A - 4A.
NAMONO BAR
City of Diamond Bar
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 & asits.
Receipts and weight tickets can be submitted to: areendb rr,diamondharca.eov
Complete before obtaining a building, combination or demolition permit.
Submit this form and your deposit to the Building and Safety Division located at: 21910 Copley Dr. Diamond Bar, CA. 91765
Applicant Contact Informatio :
Name Title AA-
Company
Address -. City V.4t ��,{,¢� k5tate�[ Zip
Phone F G-.- ( Email
Project I ormation:Indicate
Permit No �� ❑ Valley Vista ❑ WM Self Haul
Project Address Zip
Project Type: ❑ New Construction ❑ AdditionlAlteration %Demolition
.Building Type: ❑ Commercial ,Residential
Estimated Square Feet '� tp TO BE FILLED OUT BY CITY STAFF
"C&D Depos't" Paid $
Estimated Start Date ��l f
Staff Initia Date Paid �'--
Estimated Completion Date _ - -- 1 1 Z 7
FUl 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 1 Masonry 1 Tile
00
Cabinets, Doors, Fixtures,
�4
❑
Windows (circle all that apply)
Cardboard
0,00
Carpet, Padding 1 Foam
0.00
Ceiling Tile (acoustic)
0.00
Dirt
0.00
Drywall
Q, 00
Landscape Debris
0.00
Mixed C&D Debris
00
Mixed Inerts
Q,04
0.0a�
Roofing Materials
14 n t
Scrap Metal
Q,Q�
Stucco0.00
F7
Unpainted Wood & Pallets
0.00
Garbage 1 Trash
0.00
Other:
O,00
TOTAL 10.00
; 0.00
0.04
To estimate Recycling Rate: {Total AlTotal IOU = Recycling % 0.00%
Applicant Name: r' Signature: Date:
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
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