PROJECT DESCRIPTION:
Remodel/
Additions
New
Construction
Demolition/
Removal
Remodel/
Additions
New
Construction
Demolition/
Removal
3.31 4.38 115.00 2.85 3.89 155.00
0.00 0 0 0 0 0.00
ESTIMATED PROJECT TOTAL:
Estimated Generated Amount (in tons)
65% Diversion Required to Meet:
At least 65% of all generated materials must be diverted.
tons lbs
20% of Inert Debris (i.e., concrete, asphalt, dirt, etc.):
Maximum 20% of inert materials
tons lbs
Comments
Name:
Address:
City/ST/Zip:
Phone No: ( ) Email:
Same as above
Name:
Address:
City/ST/Zip:
Phone No: ( ) Email:
Project Valuation:
Deposit (3% of Valuation $1,605 min., $53,425 max)
Administrative Fee (.25% of Valuation $135 min., $2,750 max)
RESIDENTIAL
NON-RESIDENTIAL
The Construction and Demolition (C&D) Recycling Program encourages the use of green building techniques and
promotes the reuse, salvage and/or deconstruction of all recyclable materials in construction, deconstruction, and/or
demolition projects. As part of the City's committment to sustainable development, your project is required to divert
at least 65% of recyclable construction waste.
Project Type
Project Size (SF)
Lbs/sf per project type
Calculated Weight(s) in Tons
II. I further acknowledge that a copy of this C&D Management Plan will be sent to the property / business owner
listed below:
I. I acknowledge that within thirty (30) days after final inspection for the above project, the completed Final
Compliance Report (see back) shall be submitted. I further acknowledge that the amount of C&D Deposit returned
will be prorated based on the rate of compliance and that the Return of Deposit should be made payable to:
Project Address:
Date:
$
$
$
1 of 2
Construction & Demolition Management Plan
Development Services
Building and Safety Bureau
411 West Ocean Boulevard, 2nd Floor, Long Beach, CA 90802
562.570.PMIT (7648)
Facility #1
Facility #2
Facility #3
Concrete/Block/Brick
Asphalt/Aggregates/Dirt
Other
tons lbs
Drywall
Metal/scrap iron
Plastic
Roofing
Wood
Other
Total Tons Diverted - Non-Inert
tons lbs
Date
Diversion Requirement Met: Yes
No
% of Diversion Met:
Amount of Deposit: Amount to be Returned:
Final Report Approved By:
Comments:
Weights
(Ton/lbs)
Disposal Facility Name
http://www.calrecycle.ca.gov/FacIT/Facility/
Total Tons Diverted - Mixed Debris
ITEMIZED DEBRIS - NON-INERT
Total Tons Diverted - Inert
Max Allowed:
TOTAL TONS GENERATED
FINAL COMPLIANCE REPORT
Within thirty (30) days after final inspection for this project, please provide the names of all certified recyclers, salvage
companies, or recycling, mixed use or repurpose facilities, by material type, that were used for disposal of C&D debris and
the total weights of each material. Please submit the Final Compliance Report and all supporting documentation to the
Long Beach Development Permit Center or by email at Construct-Demo@LongBeach.gov
$
MIXED DEBRIS
ITEMIZED DEBRIS - INERT
OFFICE USE ONLY
%
$
I am aware that I may file an appeal to a Hearing Officer regarding any compliance ruling made pursuant to Long Beach Municipal Code
§18.67.070 within ten (10) days of the date that a ruling is made. The decision of the Hearing Officer conducting the appeal is final and is
not appealable to the City Council or to any other City body or official in accordance with of Long Beach Municipal Code §18.67.090.
To the best of my knowledge, the above information is an accurate representation of the disposition of the
construction and demolition materials generated on-site at the construction job. I understand that the City of Long
Beach may audit disposal and recycling documentation.
Name of Owner/Agent
Signature
Target Wt:
Address:
Final Date:
2 of 2
click to sign
signature
click to edit
City of Long Beach
411 W. Ocean Blvd., 3rd Floor
Long Beach, CA 90802
Visit us at longbeach.gov/lbds
LongBeachBuilds
This information is available in alternative format by request at 562.570.6257.
For an electronic version of this document. visit our website at longbeach.gov/lbds.