Appendix C - Waste Mgnt _ Diversion Guide.pdf

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Waste Management & Diversion Guide

This document is a comprehensive guide published by the City of Yucaipa's General Services/City Clerk's Department establishing requirements and procedures for construction and demolition (C&D) waste management and diversion on covered projects within the city. The guide implements Yucaipa Municipal Code Chapter 8.26 and applies to construction, demolition, and renovation projects of 2,000 square feet or greater that require building permits. Applicants must achieve a minimum 65% diversion rate of generated waste from landfills. The program consists of two phases: Phase 1 requires applicants to submit a completed Waste Management & Diversion Plan (Form A), pay administrative fees and security deposits, and obtain building permit approval; Phase 2 requires applicants to maintain on-site recycling practices during project work, submit a WMP Report Summary (Form B) and Material Handling Summary (Form C) within 30 days of project completion, and demonstrate compliance to qualify for security deposit refunds. The guide specifies exempt project categories including projects under 2,000 square feet, certain re-roofing work, residential pools and spas, and projects requiring only plumbing, electrical, or mechanical permits.

Administrative fees are $66 for projects using the city's franchise hauler (Yucaipa Disposal) or $93 for self-haul projects. Security deposits range from $500 per unit for single-family residences up to $7,500 for developments with over 20 units, and $1,000 to $5,000 for commercial buildings depending on square footage. Only Yucaipa Disposal is authorized to provide roll-off bins under the city's exclusive franchise agreement; self-haul applicants must provide proof of vehicle ownership and may only use their own vehicles. The Agua Mansa Materials Recovery Facility offers a 77% diversion guarantee for mixed C&D loads at $77.73 per ton. Applicants must maintain weight receipts from all recycling facilities and landfills; projects achieving full compliance receive a full refund of the security deposit, while non-compliance or failure to timely submit documentation results in forfeiture of the deposit and potential fines. The guide includes conversion factors for material measurement and lists approved recycling facilities for self-haul applicants.

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Text version

Rev. 08152022

General Services/City Clerk’s Department 34272 Yucaipa Blvd.

Yucaipa, CA 92399

909/797-2489

WASTE MANAGEMENT & DIVERSION

GUIDE

Phase 1

Phase 2

Covered Project 2,000 SF or greater (not exempt)

Applicant submits initial building permit application

Exempt from

WMP

Projects under 2,000 SF &/or Non-Covered

Projects

Building permit issued

Building permit finaled/expired

Pay required security deposit & administrative fee

WMP (Form A) completed and turned in to City

Compliance Official review of

WMP

WMP

Approved -

Building permit issued

WMP NOT

Approved – Permit NOT issued

Project work begins

On Site Practices:

-65% diversion -Maintain weight receipts

WMP

Compliance Official may inspect project site for recycling during course of project

Building permit finaled/expired

WMP Report Summary (Form B) and Material

Handling Summary (Form

C) submitted w/in 30 days of demo then again w/in 30 days of completion;

determine li

Project not in compliance or WMP Report

Summary not submitted

Project in full compliance

Full refund of deposit, if applicable

Fine levied;

no refund of deposit, if applicable

Waste Management & Diversion Plan Chart – Phase 1

Step 1 – Determine Applicability

Unless specifically exempted, any construction, demolition, or renovation project of 2,000 square feet or greater (covered project) within the City that requires a building permit must divert at minimum 65% of the waste generated and fulfill the requirements established by Ordinance No.

333.

The following non-covered projects are considered categorically exempt:

A project that is under the threshold of 2,000 square feet.

The re-roofing of any residential or commercial structure that does not include the tear-off of any portion of the existing roof (excluding concrete roof tiles and wood shake roofing).

Residential pool, spa, and retaining wall projects.

Projects in which only plumbing, electrical, or mechanical permit is required.

Seismic tie-down projects.

Projects where no structural building modifications are required.

Emergency demolition projects required to protect public health or safety as determined by the WMP Compliance Official.

Other projects that the WMP Compliance Official determines shall produce no, or only a de minimis quantity of, C&D waste.

Installation of pre-fabricated patio enclosures and covers where no foundation or other structural building modifications are required.

Installation of pre-fabricated accessories such as signs or antennas where no structural building modifications are required.

A project for which a valid building or demolition permit has been lawfully issued by the City prior to the effective date of this ordinance.

Step 2 – Pay Required Fees

Administrative Fee - As part of any application for, and prior to the issuance of, any building or demolition permit that involves the creation of construction and demolition debris, the applicant shall pay an administrative fee of $66 (if using the City’s franchise hauler) or $93 (for self-haul) to the City to compensate the City for all expenses incurred in reviewing the WMP and plan compliance.

Security Deposit – The security deposit shall be remitted at the same time the permit application is filed and shall be in the form of cash or cash equivalent, such as a cashier’s check, money order, or credit card payment made to the City.

The Security Deposit will be calculated based on each submitted application/phase and by the following rate schedule:

Occupancy Type # of

Units

# of Units/ Bldgs.

Sq.

Footage Deposit

Admin. Fee Franchise/ Self-Haul

Single Family 0-10 2,000-up $500/unit $66/$93 Single Family 11-20** $5,000 $66/$93 Single Family 20 > ** $7,500 $66/$93 Multi Family 0-4 $500/unit $66/$93

5-

10** $2,500 $66/$93

11-

20** $5,000 $66/$93 Commercial Bldg.

2,000- 5,000 $1,000 $66/$93 5,001- 10,000 $2,500 $66/$93 10,001-up $5,000 $66/$93

**For projects including multiple units or phases, such as a tract development, the initial deposit amount for the first permitted phase may be carried forward to the second permitted phase as long as the initial phase has received final inspection approval and is in compliance with the minimum diversion requirement (contact the WMP Compliance Official).

Step 3 – Submit completed Waste Management & Diversion Plan (WMP)

Waste Management & Diversion Plan (Form A) - Applicants are required to submit a completed WMP for any construction, renovation and demolition projects within the City requiring a permit and that meets the required threshold of 2,000 square feet or greater.

The WMP provides information regarding the project type, the estimated quantities of C&D debris generated, and the estimated quantities of materials reused, recycled, and/or disposed of (Form A is included in this packet).

Pursuant to Yucaipa Municipal Code Chapter 8.28, only the City’s franchise waste hauler (Yucaipa Disposal) is authorized to provide roll-off bins and bin service.

Please remit deposit payments to:

City of Yucaipa

34272 Yucaipa Blvd.

Yucaipa, CA 92399

NOTE: Construction and Demolition (C&D) diversion plan compliance can be certified by Yucaipa Disposal staff. Customers can request solid waste disposal and diversion records that will include total collected, waste disposed, waste diverted and a corresponding diversion rate. The Agua Mansa MRF currently offers a 77% diversion guarantee for mixed C&D roll-off loads. Customers must comply with mixed C&D program parameters in order to receive the guaranteed diversion credit. Customers requiring higher diversion for LEED certified projects will be required to source separate C&D materials into separate roll-off containers. Individual load diversion reports will be provided at an additional cost (LEED projects only). Customer inquiries can be directed via email to empire@burrtec.com.

The self-haul method of waste removal and diversion requires the applicant to use the applicant’s vehicles only. Proof of ownership and a photo of the vehicle(s) and license plate(s) are required. If a bin is removed from a vehicle, it is considered a roll-off bin, which would need to be provided by Yucaipa Disposal.

The WMP Compliance Official shall review the information supplied and approve a WMP only if the information provided is accurate and complete, the minimum diversion requirement has been met, and the applicant has paid the security deposit.

Approval of an accurate and complete WMP is a precondition to issuance of any building permit.

Step 4 – Divert Construction & Demolition Debris

At least 65% of the material that your project generates must be diverted from the landfill.

“Divert” or “Diversion” means a reduction in the waste being disposed in landfills. For covered projects including both construction and demolition, diversion of materials shall be tracked and measured separately. To the maximum extent feasible, project waste shall be separated on-site if this practice increases diversion. For construction and/or demolition projects, on-site separation shall include salvageable materials (e.g., appliances, fixtures, plumbing, metals, etc.,) and dimensional lumber, wallboard, concrete and corrugated cardboard, etc.

Applicants shall make every structure planned for demolition available for salvage, recycling, and reuse prior to demolition and to recover the maximum feasible amount of salvageable, recyclable, and reusable materials prior to demolition. Salvaged, recyclable, or reusable materials from the demolition shall be counted towards the diversion requirements of this chapter.

All waste diversion methods that qualify for a refund of the security deposit are subject to restrictions and documentation requirements approved by the City.

Be sure to keep all weight receipts issued by any recycling facility and maintain records or logs of the volume and weight of materials reused on the job site. All weight receipts for landfill and diversion as well as the amount of material reused on the job site or sent to salvage will be used to calculate the percentage of diversion for the project.

Step 5 – Apply For Security Deposit Refund

Within thirty (30) calendar days following the completion of the demolition phase of a covered project, and again within thirty (30) calendar days following the completion of the construction phase, the applicant shall, as a condition precedent to release the security deposit, submit documentation to the WMP Compliance Official, which proves compliance with the diversion requirements of this program. The documentation shall consist of:

o A completed Form B, “WMP Report Summary,” providing the weight data of materials diverted and disposed (Form B is included in this packet).

o The attached originals or photocopies of receipts and weight tags or other records of measurement from recycling companies, landfills, transfer stations, and/or the City’s franchise hauler.

In addition, where materials were recovered or salvaged recyclables and reusable materials were given away or sold on the premises, or removed to a reuse facility for storage or sale, the Applicant shall provide written supporting documentation such as letters of donation, bills of sale or other information that shall clearly document the final destination of the recovered or salvaged materials, the quantity or items that were recovered or salvaged, and the recipient of those materials.

o If a covered project involves both demolition and construction, the report and documentation for the demolition project must be submitted and approved by the WMP Compliance Official before issuance of a building permit for the construction phase of a covered project.

o If the WMP Compliance Official determines that the applicant has not made a good faith effort to comply with this program, or the applicant fails to timely submit a complete and accurate WMP Summary including supporting documentation, the deposit shall be forfeited to the city.

Form B WMP Report Summary

This report is to be completed and submitted to the City of Yucaipa General Services/City Clerks Department within 30 calendar days following the completion of the demolition phase of a covered project and within 30 calendar days following the completion of the construction phase of a covered project. The purpose of this report is to confirm that you diverted from landfilling at least 65% of the material generated by your project or made a good faith effort to do so.

Complete this form and attach original or photocopies of all receipts and weight tags from recycling companies, landfill and/or disposal companies, and submit to:

City of Yucaipa General Services/City Clerks Department

34272 Yucaipa Blvd.

Yucaipa, CA 92399

Section 1 PROJECT & APPLICATION INFORMATION

Owner’s Name : Date:

Job Site Address : ,Yucaipa, CA 92399 Permit #:

Contractor Name :

Contractor Telephone #:

Demolition Dates: Start: End:

Construction Dates: Start: End:

Total SF of Project: SF

Section 2 DESCRIPTION OF DIVERSION PLAN

� Yucaipa Disposal bins and bin service(s) were used to handle C&D waste (Proceed to Section #4.)

If Yucaipa Disposal bins and bin service(s) were not used to handle your project’s C&D waste & you were authorized to self-haul, please briefly state below how salvage and/or recycling materials were handled at your job site to ensure diversion.

(Proceed to Section #3)

Section 3 MATERIAL HANDLING SUMMARY

Please complete the Material Handling Summary Worksheet (Form C) to help identify the types of materials, quantities, and how the waste materials were reduced, recycled or disposed at your project site. For this summary report, use the actual quantities, based on weight tags, gate receipts, or other documentation. Material quantities should be calculated in tons, and the attached Materials Conversion Worksheet used for conversion factors. Fill in the diversion percentage calculated in Section F on Form C on line 3a below.

3a. Diversion Percentage Actual from Section F on Form C: ______%

3b. Is the percentage listed in 3a above greater than or equal to 65%? �YES �NO

3c. If NO, explain why:_________________________________________________

(Proceed to Section #4)

Section 4 VERIFICATION

� CITY APPROVED SELF HAUL APPLICANTS

o Attach weight receipts and other records of measurement form recycling companies and San Timoteo Landfill that show actual tonnage of diverted and not diverted materials.

� APPLICANTS THAT CONTRACTED WITH YUCAIPA DISPOSAL

o Attach the Yucaipa Disposal certified Construction and Demolition (C&D) Diversion Plan Compliance Report.

o Attach copies of invoices from Yucaipa Disposal that exhibit the use of Yucaipa Disposal bins and/or roll-off boxes for the collection of your project’s C&D waste.

Section 5 CERTIFICATION

I, the undersign, have complied to the maximum extent practicable with the Municipal Code regarding construction and demolition diversion. I hereby attest that the information in this report is true and accurate, and that at least 65% of construction and demolition materials were taken to legitimate recycling, reuse or salvage facilities as confirmed by the attached receipts.

Print Name Date

Signature

Section 6 DEPOSIT TO BE REFUNDED TO

Applicant Name

Applicant Address

Applicant Telephone Number

FOR CITY USE ONLY

Report Summary Approval Status: Security Deposit:

� Approved � Full Refund � Good Faith � No Refund � Further explanation needed � Partial Refund Amount $ � Denied

Comments:

Reviewed By: Signature

Date:

FORM C

MATERIAL HANDLING SUMMARY WORKSHEET

Use the weight receipts to fill in the table below. If any material was measured in units of volume (for example – cubic feet, cubic yards, etc.) convert it to tons using the conversion factors provided. Note:

1 ton = 2,000 lbs.

Material (A)

Recycled

(tons)

(B) Reused or Salvaged

(tons)

(C) Disposed in

Landfill (tons)

(D) Total

Quantity Generated

(tons)

(E) Facility Used/Destination

Example: Cardboard 1.5 .5 2 tons Recycle – XYZ Recycling Facility Disposal – San Timoteo Landfill

Asphalt / paving crushed 1yd3 = 1,380lbs

Brick / whole 1yd3 = 3,024lbs

Cardboard 1yd3 = 100lbs

Concrete 1yd3 = 1,855lbs

Dirt 10yd3 = 18,900lbs

Glass 1yd3 = 2,160lbs

Green Waste 40yd3 = 4,320lbs

Gypsum / Dry Wall 1yd3 = 3,834lbs

Metals 1yd3 = 906lbs

Plastic 1yd3 = 22.55lbs

Roofing 1yd3 = 418.5lbs

Tile / Ceramic 1yd3 = 1,214lbs

Wood / Scrap, loose 1yd3 = 329.5lbs

Garbage / Trash

Other:

Other:

Totals

Fill in the blanks to determine if you have diverted at least 65% of the material generated by your project:

Total Recycled + Total Reused = ÷ Total Quantity Generated X 100 = %

(A) (B) (D)

{Transfer % amount to Form B – Section 3 – Question 3a}

B/S PR Number:___________________ Form A (1) Step 3

WASTE MANAGEMENT & DIVERSION PLAN (WMP)

This document pertains to all construction and demolition projects (Covered Projects) 2,000 SF or greater.

This form is to be completed and submitted to the City of Yucaipa with your administrative fee and security deposit.

The City will issue a building permit for your project only after approval of this form.

I, the undersigned, will comply to the maximum extent practicable with the Municipal Code regarding construction and demolition diversion and will give good faith effort toward diverting at least 65% of construction materials away from landfills.

Signature:_________________________ Print Name:____________________________

GENERAL PROJECT INFORMATION

JOB SITE ADDRESS (street number and name of street) ESTIMATED START DATE:

APPLICANT’S NAME: TITLE: E-MAIL:

COMPANY PHONE NUMBER:

PROJECT DESCRIPTION

Project Type: New Construction � Demolition � Renovation

Building Type: Non-Residential � Residential � Multi-Family Residential

PROJECT PROPOSED DIVERSION METHOD

� Yucaipa Disposal (909)797-9125* � Self-Haul** � End Dump Trailer

� C&D Account is set up � Company Name:

� C&D Account Number:___________________

Must set up separate account for project waste/recycling.

Inform Yucaipa Disposal you wish to open a C&D Account.

Proof of established account. Must set up prior to permit being issued. If diversion is not conducted, inspections will cease.

Proof of Ownership & photos of:

(Required for Self-Haul only)

� Truck � Vehicle License Number

� Registration � Yucaipa Business License

*Yucaipa Disposal has an exclusive Franchise Agreement with the City of Yucaipa.

**Please note that self-haul means the use of the applicant’s vehicle(s) only. If a bin is removed from a vehicle, it is considered a roll off bin, which would need to be provided by Yucaipa Disposal.

**Owner/Contractor self-haul entails equipment ownership, including truck, container and company staff. Proof of equipment ownership & photo documentation is required if you are selecting this diversion method.

Disposal and Recycling Information

How will waste be handled during your project?

� Job Site Separation: Material will be segregated into two or more material-specific bins. For example, one bin for concrete, one for metal, one for wood, one for trash, etc. Note: Bins must be provided and serviced by the City’s franchise waste hauler.

� Collection and delivery of mixed loads to a Material Recovery Facility: Clean construction and demolition materials are commingled into a bin. The mixed loads are then delivered to a materials recovery facility for sorting.

Trash should be collected in a separate bin and delivered to a landfill. Note: Bins must be provided and serviced by the City’s franchise waste hauler.

Diversion Security Deposit Unless categorically exempt (see project types listed under Step 1), each applicant, for a building / renovation / and/or demolition permit, shall post a deposit in an amount based on square footage of the project.

Determine your deposit amount by using the table in Step 2. List your deposit amount here: $______________

FOR CITY USE ONLY

Date:_____________________ WMP approved or WMP denied or Exempt

Security Deposit Paid $__________ (Act. # GS011) $66/$93(franchise/self-haul) Admin. Fee Paid $__________ (Act. # GS002)

Reviewed/Approved By: ____________________________________________

APN:___________________

PR Number:___________________

SQUARE FOOTAGE OF

PROJECT:

UNITS / PHASE:

YUCAIPA, CA 92399

Rev. 08152022 carvizu Rectangle carvizu Rectangle carvizu Rectangle carvizu Rectangle carvizu Rectangle

Form A (2) Place a check mark next to the types of materials you intend to generate during your project. Then place a check mark next to the handling method(s) you intend to use.

Material to be Generated Material Handling Method

Asphalt Recycle Reuse/Salvage Dispose in Landfill

Brick Recycle Reuse/Salvage Dispose in Landfill

Building materials (ceiling tile, windows, fixtures, etc.)

Recycle Reuse/Salvage Dispose in Landfill

Cardboard, Paper Recycle Reuse/Salvage Dispose in Landfill

Carpet, Carpet Padding Recycle Reuse/Salvage Dispose in Landfill

Concrete Recycle Reuse/Salvage Dispose in Landfill

Dirt Recycle Reuse/Salvage Dispose in Landfill

Glass Recycle Reuse/Salvage Dispose in Landfill

Gypsum/Dry Wall Recycle Reuse/Salvage Dispose in Landfill

Metals Recycle Reuse/Salvage Dispose in Landfill

Mixed C&D Recycle Reuse/Salvage Dispose in Landfill

Plastic Recycle Reuse/Salvage Dispose in Landfill

Rock Recycle Reuse/Salvage Dispose in Landfill

Roofing Recycle Reuse/Salvage Dispose in Landfill

Tile (Ceramic) Recycle Reuse/Salvage Dispose in Landfill

Wood (lumber, doors, etc.) Recycle Reuse/Salvage Dispose in Landfill

Other: Recycle Reuse/Salvage Dispose in Landfill

Refuse Dispose in Landfill

C&D Diversion Program Services July 1, 2022

RECYCLING

Service Fees 10 cubic yard demo box $250.12+ applicable processing fee 40 cubic yard box $250.12 + applicable processing fee (includes 7 day container rental charges)

Processing Fees Mixed C&D: $77.73/ton (includes 74.02% diversion guarantee) Green Waste: $57.79/ton Blonde Wood Waste (clean lumber, fencing and untreated wood): $30.63/ton Manufactured Wood Waste (plywood, compressed wood, treated wood): $54.00/ton Inerts (rock, gravel, concrete, dirt, tile, ceramic, red brick): $100.00/load Clean Dirt or Concrete: $100.00/load Carpet: $49.93/ton Drywall: $67.00/ton Palm: $65.00/ton

Scenario: Large volume 15 tons

1) Multiple source separated roll-off boxes

One Blonde Wood – 40 yard box with 5 tons: $250.12 + $153.15 = $403.27 One Concrete – 10 yard box with 8 tons: $250.12 + $100.00 = $350.12 One Green Waste – 40 yard box with 4 tons: $250.12 + $231.16 = $481.28

2) Multiple mixed C&D roll-off boxes – all C&D material in the same box

Two loads mixed C&D – 40 yard boxes with 7.5 tons each: $250.12 + $582.98 = $833.10 x 2 loads = $1,666.20 (includes a 74.02% diversion guarantee)

Scenario: Small volume 4 tons

Mixed C&D – 40 yard box with 4 tons: $250.12 + $310.92 = $561.04 (includes a 74.02% diversion guarantee)

REFUSE

20 cubic yard box (4 tons) $483.70– 7 day container rental charge 40 cubic yard box (6 tons) $594.52– 7 day container rental charge Excess disposal fee - $55.56/ton Temporary bin 3 cubic yard (3 week use) $115.14

SAN TIMOTEO LANDFILL

Self-haul scenario $59.94/ton – no diversion

WASTE MANAGEMENT & DIVERSION RECYCLING GUIDE

FOR SELF-HAUL QUALIFYING APPLICANTS ONLY

Contractors are discouraged from taking any recyclable material to the landfill. Material disposed of at the landfill will not be given C&D recycle credit. Please recycle your recyclable material at a recycling center and request a receipt with verifiable tonnage.

Verified weight receipts (both disposal and recycling) must be obtained and turned in along with the WMP Report Summary within 30 days following the completion of your construction project.

The City of Yucaipa has confirmed that the companies on this list recycle/divert material. If you use another company, it is your responsibility to confirm that the material is recycled.

Contractor Address Phone Number

Materials

Agua Mansa MRF Transfer Station

1830 Agua Mansa Road Riverside, CA 92509

951-786-0544 (must mention C&D program for recycle credit) clean loads are cheaper

West Valley MRF Transfer Station

13373 Napa Street Fontana, CA 92335

909-899-5501 (must mention C&D program for recycle credit) clean loads are cheaper

Advanced Steel Recovery 14454 Whittram Ave., Fontana, CA 92335

909-355-2372 Metallic Scrap - No Aluminum, Glass, or Plastic Cans

Amazon Environmental Inc. 779 Palmyrita Avenue Riverside, CA 92507

951-588-0206 Water based paint ONLY

Amigos Recycling 27170 5th St., Highland, CA 92346

909-864-9215 CRV's/Scrap Metal/Plastics (No tin or iron)

Amko Recycling Center 340 W. Valley Blvd., Colton, CA 92324

800-598-3058 Cardboard/Glass/Scrap Metal/Paper & CRV

C & B Crushing 13552 Calimesa Blvd.

Yucaipa, CA 92399

909-446-0100 Asphalt/Concrete

Dan Copp Crushing 861 W. 4th Street Beaumont, CA 92223

800-DUMPSITE Asphalt/Concrete

Golden State Recycling 32210 Dunlap Blvd.

Yucaipa, CA 92399

909-570-4002 Metal/Aluminum/Copper/Brass & CRV

One-Stop Landscaping Supply Center

13024 San Timeteo Canyon Rd., Redlands, CA 92373

909-798-1278 Green Waste/Wood/Concrete

WASTE MANAGEMENT & DIVERSION

Statement of Understanding

I, , hereby acknowledge and declare that:

I am aware that the City of Yucaipa’s Waste Management & Diversion Plan (as set forth by Yucaipa Municipal Code (YMC) §8.26.030 and §8.26.110 of the City’s construction and Demolition Waste Diversion Ordinance) has been provided to me and that it is my responsibility to familiarize myself with this Plan and its requirements.

In addition, I agree to conduct my activities in accordance with the Waste Management & Diversion Plan and understand that failure to comply will result in the forfeiture of my deposit.

Signed:_______________________________

Date:_________________________________

undefined:
Permit:
undefined_2:
Contractor Telephone:
Start:
End:
Start_2:
End_2:
materials were handled at your job site to ensure diversion 1:
materials were handled at your job site to ensure diversion 2:
materials were handled at your job site to ensure diversion 3:
materials were handled at your job site to ensure diversion 4:
undefined_3:
3b Is the percentage listed in 3a above greater than or equal to 65 YES NO:
3c If NO explain why:
undefined_4:
taken to legitimate recycling reuse or salvage facilities as confirmed by the attached receipts 1:
Date_2:
1:
2:
Applicant Telephone Number:
Brick whole 1yd3 3024lbs:
Concrete 1yd3 1855lbs:
Glass 1yd3 2160lbs:
Green Waste 40yd3 4320lbs:
Gypsum Dry Wall 1yd3 3834lbs:
Metals 1yd3 906lbs:
Plastic 1yd3 2255lbs:
Roofing 1yd3 4185lbs:
Tile Ceramic 1yd3 1214lbs:
Wood Scrap loose 1yd3 3295lbs:
undefined_5:
undefined_6:
undefined_7:
X 100:
PR Number:
BS PR Number:
APN:
ESTIMATED START DATE:
APPLICANTS NAME:
Yucaipa CA 92399:
EMAIL:
COMPANY:
PHONE NUMBER:
SQUARE FOOTAGE OF PROJECT PER APPLICATIONPHASE:
Company Name:
CD Account Number:
Determine your deposit amount by using the table in Step 2 List your deposit amount here:
Print Name:
Recycle:
ReuseSalvage:
Dispose in Landfill:
Recycle_2:
ReuseSalvage_2:
Dispose in Landfill_2:
Recycle_3:
ReuseSalvage_3:
Dispose in Landfill_3:
Recycle_4:
ReuseSalvage_4:
Dispose in Landfill_4:
Recycle_5:
ReuseSalvage_5:
Dispose in Landfill_5:
Recycle_6:
ReuseSalvage_6:
Dispose in Landfill_6:
Recycle_7:
ReuseSalvage_7:
Dispose in Landfill_7:
Recycle_8:
ReuseSalvage_8:
Dispose in Landfill_8:
Recycle_9:
ReuseSalvage_9:
Dispose in Landfill_9:
Recycle_10:
ReuseSalvage_10:
Dispose in Landfill_10:
Recycle_11:
ReuseSalvage_11:
Dispose in Landfill_11:
Recycle_12:
ReuseSalvage_12:
Dispose in Landfill_12:
Recycle_13:
ReuseSalvage_13:
Dispose in Landfill_13:
Recycle_14:
ReuseSalvage_14:
Dispose in Landfill_14:
Recycle_15:
ReuseSalvage_15:
Dispose in Landfill_15:
Recycle_16:
ReuseSalvage_16:
Dispose in Landfill_16:
Recycle_17:
ReuseSalvage_17:
Text1:
Text2:
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Text7:
Asphalt paving crushed 1yd3 1380lbs:
0:
0:
1:
2:
3:
4:
1:
1:
2:
3:
4:
Cardboard 1yd3 100lbs:
0:
0:
1:
2:
3:
4:
1:
2:
3:
4:
1:
0:
1:
0:
1:
2:
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2:
0:
1:
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3:
0:
1:
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0:
1:
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0:
1:
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0:
1:
2:
3:
7:
0:
1:
2:
3:
8:
0:
1:
2:
3:
9:
0:
1:
2:
3:
Other:
0:
1:
2:
3:
4:
Text8:
0:
1:
2:
Other_2:
0:
1:
2:
3:
4:
Totals:
0:
1:
2:
3:
Text9:
Check Box10:
0:
0: Off
1: Off
2: Off
3: Off
1:
0: Off
1: Off
2: Off
3: Off
2:
0: Off
1: Off
2: Off
3: Off
3:
0: Off
1: Off
2: Off
3: Off
Check Box11: Off
Check Box12: Off
Row1:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
0:
0:
1:
2:
3:
4:
11:
0:
1:
Dispose in Landfill_17:
0:
1:
Text13:
I:
Signed:
Date:

File details come from the government source that posted it. Updated .