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Home My WebLink About625 Peterson St - Correspondence/Plans Approval - 08/07/2017City or F tIlls Community Development & Neighborhood Services 281 N. College Ave. Fort Collins, CO 80522; Voice: 970-221-6760 FAX: 970-224-6134 CONSTRUCTION. WASTE MANAGEMENT PLAN and DOCUMENTATION Note: City staff is able to assist if you have questions about implementing a construction site recycling program, please call Jonathon Nagel at (970) 416-2701. PROJECT INFORMATION Address(es) 625 Peterson St Permit #(s) B 1605752 General Contractor & Contact Info: SWIFT BUILDERS 970-682-4230 Instructions: Submit the construction waste management plan at the beginning and end of each project. At first submittal, do not include the total volume/weights, hauler signatures or documentation. At project completion resubmit this plan, with ALL fields completed, along with the required documentation. If one or more materials were not generated during the project, indicate as such. Documentation: Provide documentation from the hauling company listing the project address and services provided. If you hauled the materials yourself, attach tickets from all facilities recycling the materials. Material Vendor hauling the material Facility recycling the Total volume or weight of material Indicate if self -hauled material Indicate units Concrete/Masonry (Required) Self -Hauled City Crushing Facility y 9 y 1.57 tons W(Required) (Required) S&B/WM Hagemans Earth Cycle 1.87 tons Metals (Required) N/A N/A N/A Cardboard N/A N/A N/A (Required) Trash S&B/WM N/A 22.66 Contaminated loads (Intended recyclables, sent S&B/WM N/A 3.37 tons -Wood to landfill. Indicate material) I understand that my failure to follow this plan or resubmit this plan could include penalties of over $2,500 per day of the violation and up to six months in iail. I certify that the above materials from my construction site were recycled in the volume / weight described and were to to the facilities described. MIKE- 1YL64(1:1 �Y �, �� 08/07/2017 Print Name & Signature - Contractor or Owner Date Print Name & SignfLke - Hauler(s) (If multiple, indicate vendor and include signature from each) 8. 8.1 Date Rev6-1-'-017 wnsre ry n�ui►GEiwwEror North weld Landfill 400i WGR 2 AUz F p T TZy 6061EI Ph: (97e) Gas•- O Original Ticket€ 16@575$ D!Gti:46n Nan 5BPOR4ABOWLRESTRf OMS SO PORT Carrier SR WASTE SERVjCE i Ticket -Date 04/25/M7 Vehicle# k-ic Volune Payevnt Type Cpedit account Container Drive P Che -k# rco� to Billing # State 't?ante Code Gen EPA TU Mar, i.f�&+ ICefitination PB Profile 0 Genera . or Tiwe 10 04I05/2017 10.4 :28 Di It 04105/eOI7 10:44:08 T om dents at -id, Tit - Dund GPOS$ 3182a tt Tare e844 lb Net -3341 Ib Tons .1. 67 `raduet LLB. Oty UM Rate - rax 1 PISHT-TONS IM9 ie67 Tons FUEL -Fuel 2urcharg 160 K. RCR-P-Regulatory C 100 4 EVE-PS--Enviftnment 106� F { r 404WM-N ilnbunt: Origin Total Tax Total Ticket �08 w no WASTE MANAGEMENT C 404WM-N Cl"),2719537 ow tj I R Site Specific Waste Report to Date Customer: Account: Project: Proj. Address: City, State: Contact Info: Project Dates: Swift Builders 62S S Peterson St Fort Collins Carlos Gonzalez 970-534-0144 carlos(cDsbarestrooms.com wa�seR�� Facility Facility Location Commodity Ticket # Haul Date Account # Weight unit 01 Measure North Weld Landfill Ault General Debris 1559362 10.5.16 1.92 Tons North Weld Landfill Ault General Debris 1569101 10.7.16 1.76 Tons North Weld Landfill Ault General Debris 1569101 11.11.16 0.88 Tons North Weld Landfill Ault General Debris 1593164 2.22.17 2.4 Tons North Weld Landfill Ault General Debris 1600284 3.20.17 3.25 Tons North Weld Landfill Ault Wood load contaminated 1604053 3.30.17 1.64 Tons North Weld Landfill Ault General Debris 1605759 4.5.17 1.67 Tons North Weld Landfill Ault Wood load contaminated 1607904 4.12.17 1.73 Tons North Weld Landfill Ault General Debris 1608389 4.13.17 1.36 Tons Ha eman Earh Cycle Fort Collins Wood 562 4.19.17 ,, 1.87 Tons North Weld Landfill Ault General Debris 1613057 4.28.17 2.44 Tons North Weld Landfill Ault General Debris 1617306 5.12.17 3.78 Tons North Weld Landfill Ault General Debris 8/21/6338 5.25.17 3.2 Tons Total Debris: 26.03 Tons ,)Nood ':_Recycling 1.87 Tons Mobile Scale `ransaction No. Phone: 970-482-1249 2067079 Have a nice day! Inbound Material Hauler: INBOUND 3 INBOUND MATERIAL :ustomer: 0319 INBOUND MATERIAL Iaterial: 100 - Concrete Price )perator: JR:Jessica Roush '0: :omments : i )RIVER'S COPY Date Time In: 03/10/17 10:07 Out: 03/10/17 10:07 lb to I Scale Gross: 9420 4.71 MAN WT Tare: 6280 3.14 MAN WT $0.00/na Net: 3140 1 1.57 Subtotal: $ 0.00 Tax: $ 0.00 Total: $ 0 1.57 Tons - 1 Loads City of Fort Collins Mobile Scale ransaction No. Phone: 970-482-1249 2067079 Have a nice day! Inbound Material Hauler: INBOUND 3 INBOUND MATERIAL 'ustomer: 0319 INBOUND MATERIAL Iaterial: 100 - Concrete Price: $0.00/na )perator: 'O : .omments: )FFICE COPY JR:Jessica Roush Date Time In: 03/10/17 10:07 Out: 03/10/17 10:07 lb to Scale Gross: 9420 4.71 MAN WT Tare: 6280 3.14 MAN WT Net: 3140 1.57 Subtotal: $ 0.00 Tax: $ 0.00 Total: $ 0 1.57 Tons - 1 Loads City of Fort Collins Mobile Scale Date Time 'ransaction No. Phone: 970-482-1249 In: 03/10/17 10:07 2067079 Have a nice day! Out: 03/10/17 10:07 Inbound Material lb to Scale Hauler: INBOUND 3 INBOUND MATERIAL Gross: 9420 4.71 MAN WT :ustomer: 0319 INBOUND MATERIAL Tare: 6280 3.14 MAN WT Iaterial: 100 - Concrete Price: $0.00/na Net: 3140 1 1.57 )perator: JR:Jessica Roush 'O: :omments: ;CALE COPY >ignature: Subtotal: $ 0.00 Tax: $ 0.00 Total: $ 0 1.57 Tons - 1 Loads WASTE-MAMAGEMEWT .. Weld ee i:'i�.e�.ELandfill }Norry,,�tepryh. WCR AULT, CQ _ am l0 ph: (970) 686-ZSOO Customer Name fiBRQRTABOWL.EtESTROOMS S&P ORT Carrier 6 T3.r_ke late 0151�151 Vehicle# 4 Payment Type Credit Account Container Man"Nl Ticket# Driver Hauling. Tit:keG# Check, Route", Billing .g State .WaGte Code Gen EPA 'ID Manifest Destination Grid Pn B-WASTE SERVICE Volume S f.%0010399 Profile t �7 L'ieneF's3t4?' � E III Out Tint= �`, 'F C1iau1'airo�= Inbound Grout 16540 ib 415/,S/"'- -f O''3.06aa16. ZD ' 9 to Tare I 0 /,'-_ /2#w1 09r0ea06 1 Ty i i t a, Net e1400 I i C L- , ----- areenta Toni 3.! -. _ \+..ilr ri3 v2 -�J .. .tea �i !. /!,^ _JL V':-;t•.;r .. s. l._F i. ,i i...� Product Ltd% >. 3ty . 11 M .Rate Tau Awnunt Origin +---- — -rt.' ra+rraR+e--.r-----ee.n------rw �rwnwr�Rw....�+sr+w.ssr�..«rt r+esF�+lrr:nw4.aar+M'?s4vnrr H.w+va.aw.!!t4aa+Wr. i 14SWT-TLNG too 3.20 Tans 2 FUEL -Fuel: aurcharg 1014 X > REiR^i�-Reg�tlatory C± 3.00 �> a„ 4 EVF-M-Environmont 100 Total Tax'' Total Ticket e ,riwsr�mawna�lwEnr North Weld Landfill 4Q+4 L1CR '25 RULT, C4, 8%19 Ph (9781 &M-MO Custdmer Wane FUMRTABOWL.RESfRtiCfFtS 59B PORT Carriar t .cket' Date M/Ia/22017 VehicleO Raywefit Type 'Credit Account Container Manual Ticket* i2rivar Hauling Ticket* Check# Route Billing a State waste Code Son EPA I D t s Tine 1 ata r+ In pund In Out 05/ 1212017 : ,k� Rr24 1 Coacentu �l s V. j Gros$ 377M 1b 1 Tare 10146 1b Not TSW I a Tarts i Product L.D% Qtq UIR4 Rate Tax Gloount origin ^ NSbdT-TtllsiS �1em - 3.78 Tuns-_, FLiEL-fuel Surcharg' iN 5C � 3 RCR-P-Regulatory C 100 x 4 EVR-P6-Envirenoont 109 1t V Total Tax Total Ticket 1. 404WM-N -.'ISM*arras+'•c ��w».�nt^e -�..� t, -1/ wnsre M.IAM4 IMEUr Worth Weld Landfill 4eM WCR 28 AULT, C% 80610 Ptt: (971D) 686-=2M Clidtnadr Nape NPORTABOWLRESTROOP M PORT Carrier Ticket Date 04/28/2017 VehicleO Raycont Type Credit Account C.ontoiner Manual Tiekett Driver Hauling Ticket## Check#) Route Billing 0 State Waste Code Oen EPA ID ian>fet Grid Dentknat on 1-43 Profile 0 w e 12-21071 Original Tickoto 161=7 SB WASTE SERVICE 4-12' Volume Bererator Tide In 04d2812OU 08i38e29 Out o4/28/2017 08iMs29 Gotsderrfa o 0,1' qr 1. bou Gross 3USO lb Tare 284M IRS olb T489e 44 � Tans 2.44 i'rnc#ttct.. LD% aty UM Rate Fee fidesint Origu r ., __; e,. _ . -- • -__. _ _ _ .�_�.. , __�__..M .___ :....._........:w--- tea_. 1 tCt4T -TMS 100 2.44 Tono C t1EL1 Fuel Sureharg Ift x 3 MR--P--€tegulatory C too k f< • EslF-F=6vironnent 1�1�d 5i . Tare% Fees Total Ticket I SCALE TICKET NO.5602 BUYER: 5- COMMODITY: REMARKS: Hageman Earth Cycle, Inc. 3501 E. Prospect Rd Fort Collins, CO 80625 TONS: 'WAWM MANAMEMEW North Weld Landfill, WOM WCR 25 AULT,, M, .806113, Ph: '(970) 686-:2W* C4stam�v Name SBPORTABOWLRESTROOMS SSE PORT eairrier= SS' WI-19TE MRVICE 1281069 Original Ticket# 16883eS 'VICKetUatG IA4/1312017 velhiclu# I-1p- Vayment Type . Credit j:L-cotint fdaht-tal Ticket* Container Driver 5 Hauling Ticket# te Cbeck# Billing # ftla�tlq' MsDe Code St a.t.,i Zs Gen EPA ID " '14ailifv.dt 0001bation too cPl PO Ovid tq% Prafil6 Generator al Time a n, In und Gross 31aO lb In 04/13f2ell 10 2 IM i5 Tare ;-:?13940 1h 01A 04/13/C-t17 10:51.2.5 R#t I Mee 11b 0 Tslps 1,36 Covoints ptkodw-t LJ)% uty UQM Rate Tax Anount leg 1.36 Tons a 5UL-L-Fuel Surchbrg NO 13 C Joe 4 Eup-ps-cr' v i lAunuent I N Total TaR total Tiptet 404WM-N ............ 0