COUNTY OF SAN BERNARDINO County Use Only

DEPARTMENT OF PUBLIC WORKS, SOLID WASTE MANAGEMENT DIVISION Date Paid

Construction Waste Management Plan Amt
Initials
Complete this form for the following projects and check appropriate selection (s):
All newly constructed single family residences of one unit. (FEE $55.00)
All new commercial and/or industrial construction projects (FEE $165.00)
All newly constructed low rise residential buildings of three or less stories* (FEE $165.00)
APN: Date: Permit #
Project Name:
Project Address:
Owner's Name:
Owner Telephone:
Mail Address:
Contractor Name:
Contractor Contact:
Contractor Telephone:
Approximate sq ft of Project:
Demolition Dates: Start: Finish:
Construction Dates: Start: Finish:
Brief Description on Project:
1. Property/Disposal Information
Property Management Group Name (if applicable):
Property Management Group Phone Number (if applicable):
Size and quantity of all solid waste containers proposed for use:
Size and quantity of all recycling containers proposed for use:
Frequency of Solid Waste/Recycling Pickup Services:
Waste Hauler (required)**:
COUNTY OF SAN BERNARDINO, SOLID WASTE MANAGEMENT DIVISION, SPECIAL PROJECTS UNIT 222 W HOSPITALITY LN 2ND FL, SAN BERNARDINO, CA
92415-0017 BUSINESS HOURS: M-F 8AM TO 5PM - 909-386-8701 - WWW.SBCOUNTY.GOV/DPW/SOLIDWASTE
Submit completed recycling plans to Solid Waste Management for review prior to permit issuance.
The intent of this form is to ensure a minimum of 50% diversion of construction building materials and demolition debris from landfills and compliance with State Law
which states that 50% of non-hazardous construction and demolition debris be recycled and/or salvaged for reuse thereby extending the life of the landfills. All
contractors/subcontractors shall comply with the project C&D Waste Management Plan (CWMP).
**San Bernardino County Code Section 46.0102 requires persons engaging in solid waste handling services to have a franchise agreement
with the County or a Class A Permit except as provided for in the Code Section.
*Including hotels, motels, lodging houses, apartment houses, condominiums, dormitories, shelters, congregate residences, employee housing, other dwellings containing sleeping
accommodations without toilets or cooking facilities, accessory buildings, facilities and uses related to other described structures.
REV. July 2011 Please use recycled content paper.
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2. Responsibility For the Plan
3. Exemption
4. Verification
Prepared By: Date:
Signature:
Print Name:
Title:
Plan Approval Status: Exemption Status:
Approved Exemption Approved
Further explanation needed (see attached) Exemption Denied
Denied
Comments:
Reviewed By: Signature:
Land Use Permit # Date:
Date: Documentation Requested Documentation Provided
Comments:
Reviewer's Name: Reviewer's Signature:
Reason: Approved: Not Approved
** FOR COUNTY USE** PART II ONLY ACTUAL TONNAGE (PRIOR TO OCCUPANCY)
50% Diversion: Good Cause: Non-Attainment:
** FOR COUNTY USE** PART I ONLY ESTIMATED TONNAGE (PRIOR TO BLDG PERMITS)
Please fill out the section below if you believe that your project is entitled to an exemption and should not be required to divert or recycle
C&D debris.
"To the best of my knowledge, the tonnage and diversion percentage estimates reported on this form are my best estimate of the
disposition of construction and demolition materials generated at this project site."
Briefly state who will be responsible for the collection and management of construction materials and how employees/contractors handle
waste materials at the project site to ensure salvage/reuse or recycling. Also explain how you will inform your workers/contractors of your
CWMP requirements and ensure their participation:
REV. July 2011 Please use recycled content paper.
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5. Material Handling Estimate Tonnage
APN Address
B
Salvaged or
Reuse
15
Comingled Sorting Sorted on site
5a. (Total Column B + Total Column C)/ Column A = # x 100% = Total Diversion Percentage %
5b. Is the percentage listed in 4a greater than or equal to 50%? Yes No
5c. If NO, please explain why:
Cabinets/Fixtures/W
indows/Doors/Equip
ment
Cardboard
Plastic Pipe
Plastic (misc)
Other (specify)
Carpet/Padding/Foa
m
Glass
Garbage (non-
recyclable)
TOTALS
Wood, Pallets &
Lumber
Toner Cartridges
Rigid Insulation
Electronics
Gypsum Drywall
Organic Debris
Office Recyclables
PART ONE (Prior to Bldg Permits) : ESTIMATED MATERIAL DISPOSAL/DIVERSION WORKSHEET (In Tons)
Please complete this Worksheet to help identify the types of materials, estimated quantities, and the waste material that will be reduced,
recycled or disposed from your project site. Estimates should be calculated in tons and use the attached Materials Conversion Table on the
last page for conversion factors if needed. Fill in the estimated diversion percentage calculated on line 5a below.
Scrap Metal (all
types)
Recycled Mixed
Debris
Brick/Masonry/ Tile
Project Name
A C D
12
Onsite Packaging & John Smith
Recycling Center
E
Material Type
Total Quantity
Construction Wastes Recycling
Disposal (non-
recyclable) Proposed Destination(s)
Example: Paper 62 35
Acoustical Ceiling
Tiles
Batteries
Asphalt & Concrete
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6. Material Handling Actual Tonnage
APN Address
B
Salvaged or
Reuse
15
Comingled Sorting Sorted on site
6a. (Total Column B + Total Column C)/ Column A = # x 100% = Total Diversion Percentage %
6b. Is the percentage listed in 5a greater than or equal to 50%? Yes No
6c. If NO, please explain why:
Asphalt & Concrete
PART TWO( Prior to Occupancy): ACTUAL MATERIAL DISPOSAL/DIVERSION WORKSHEET (In Tons)
Please complete this Worksheet to help identify the types of materials, estimated quantities, and the waste material that will be reduced,
recycled or disposed from your project site. Estimates should be calculated in tons and use the attached Materials Conversion Table on the
last page for conversion factors if needed. Fill in the estimated diversion percentage calculated on line 6a below.
E
Material Type
Total Quantity
Construction Wastes
Brick/Masonry/ Tile
Cabinets/Fixtures/W
indows/Doors/Equip
Cardboard
Carpet/Padding/Foa
m
Electronics
Garbage (non-
recyclable)
Glass
Gypsum Drywall
Office Recyclables
Organic Debris
Other (specify)
Plastic (misc)
Plastic Pipe
Recycled Mixed
Debris
Rigid Insulation
Scrap Metal (all
types)
Toner Cartridges
Wood, Pallets &
Lumber
TOTALS
Onsite Packaging & John Smith
Recycling Center
Project Name
A C D
Disposal (non-
recyclable) Actual Destination(s)
Example: Paper 62 35 12
Acoustical Ceiling
Tiles
Batteries
Recycling
REV. July 2011 Please use recycled content paper.
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7. Conversion Information (All Projects)
For more conversion factors, please visit: http://www.calrecycle.ca.gov/LGCentral/Library/dsg/ApndxI.htm
Single Family Residential ONLY
Table 2: NAHB Construction Waste Estimate of a Typical 2000 Sq-Ft House
50
11
-
1
1
8000
1050
50
1000
150
2000
Solid Dimensional Wood
1
20
6
5
6
150
1400
1600
MATERIAL WEIGHT (LBS) VOLUME (CU.YD)
Engineered Wood
Cardboard
Drywall
600
Total
Other
Hazardous Materials
Masonry
PVC
Metal
Carpet 84 0.04
Concrete 1855 0.93
Brick 3024 1.51
Cardboard 100 0.05
Asphalt 1380 0.69
68 0.03
Material Pounds/CY Tons/CY
Acoustical Ceiling Times
Drywall 1620-2160 0.81-1.08
Glass (Window) 80-100 0.04-0.05
Mixed C&D Debris 900 0.45
Mixed Office Recycling 363.5 0.18
Mixed Plastics 32 0.02
Mixed Waste/Trash 100-350 0.05-.0178
Plastic Pipes 341 0.17
Scrap Metal 906 0.45
Wood (chipped) 500 0.25
Organics (brush, chips, pine needles, stumps etc.) See Below
Brush (prunings) 47 0.02
Pine Needles 74 0.04
In the event that the contractors/subcontractors furnish their own debris boxes as part of their scope of work, such contractors shall not be excluded from complying with the
waste management plan and will provide the signatory of this plan with disposal weight and waste diversion data for their debris boxes.
In the event that site use constraints (such as limited space) restrict the number of debris boxes that can be used for collection of designated waste the project Superintendent
will, as deemed appropriate, allocate specific areas onsite where individual material types are to be consolidated. These collection points are not to be contaminated with non-
designated waste types.
Stumps 1080 0.54
Metals 906 0.45
REV. July 2011 Please use recycled content paper.
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