D-2016-0358 Recyclable Materials Form�" '2 `'f r""' City of Cupertino
" 1 Public works Department
I UIPM71 Environmental Programs Division
�, 10300 Torre Ave
Cupertino, CA 95014
'CUPERTINO GREEN
rrogrom (408) 777-3354
Construction and Demolition Recycling Diversion
Requirements and Instructions
Covered projects, or all construction, demolition and renovation projects that are 3,000 square feet or more
are required to complete a Waste Management Plan for the City of Cupertino demonstrating that 60% of the
material generated is recycled, in compliance with ordinance CMC 16.72.050. At the conclusion of the project
a Construction Recycling Report must be filed with the Public Works Department/Environmental Division
showing the tons recycled and disposed by material type. Use tonnage information from weight tags provided
by facilities to quantify total estimated waste and percentages for materials. Weight Tags of all material
recycled and disposed must be submitted with the final report in order to receive a Final Building
Inspection.
Recology is the only debris bin service provider franchised to do business in Cupertino.
Debris from a project 3,000 square feet or more in Cupertino can be collected and
disposed by using:
Please check all that apply:
❑ I am not using a Recology debris bin, however, the project is less than 3,000 s.f., e.g, buildings, patios,
sidewalks, driveways.
❑ I will use a Recology debris bin. By Agreement with the City, Recology will prepare my required
Waste Management Plan & Recycling Report. Contact Recology: (408) 725-4020.
I am not using a Recology debris bin. I will provide the following submittals to the City's Public
Works Department, showing that I have recycled at least 60% of all construction demolition material:
Ask for the Construction & Demolition Recycling Packet from the Building Department and
complete the following:
✓ Submit a Construction and Demolition Waste Management Plan with your buildingpermit
application. No fee for this plan. Forms are available at the Building/Public Works counter and online
at www.cupertino.org/environmental. Report the tonnage recycled and disposed, by material type.
Recycling facilities must be selected from the City's approved list of Recycling Resources.
✓ Submit a Construction Recycling Report form. The report is required before the Building
Department will schedule a final inspection. The report form is available at the Building/Public
Works Counter and online www.cupertino.org/environmental.
Signature:
Name:
Title:
Phone:
Project
This form to remain in the project's building permit file for the duration of the project.
Revised 317112 1