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15010079CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20688 HOMESTEAD RD CONTRACTOR: TRI-QUEST BUILDERS & PERMIT NO: 15010079 DEVELOPERSINC OWNER'S NAME: SOBRATO INTERESTS 1 ETAL 2280 GRASS VALLEY HWY #200 DATE ISSUED: 05/27/2015 OWNER'S PHONE: 3033765375 AUBURN, CA 95603 PHONE NO: (916) 923-0333 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL _ S 3� q 67q CHIPOTLE - T.I. TO BUILD OUT NEW RESTAURANT (1,884 License Class_ Lic. # S.F.) Contractor Tt; — d(/CS T Date �— 15 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $250000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32610066.20688 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 T CALLED INSPE TIO . indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the �� ;=o*4- granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. .��/ Signatur: _ Date2 rf�_ l9 RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: ���� permit is issued. z� I certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. Work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date O CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinq@cupertino.orq [:1 NEW CONSTRUCTION [I ADDITION [K ALTERATION / TI El REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 20688 Homestead Road Cupertino, CA 95014 —7APN I # 326-10-066 - OWNER NAME Chipotle Mexican Grill, Inc./ b PHONE (303) 376-5375 E-MAIL jhayashi@chipotle.com STREETADDRESS 1401 Wynkoop Street, Suite 500 CITY, STATE,ZIP Denver, C080202 FAX CONTACT NAME Sean Gibbons, project man ger - HA Architects PH N (402) 895-0878 E-MAIL sgibbons@fhaarchitects.com 650 - STREET ADDRESS I CITY STATE, zipj Omaha, Nebraska 68137 4344 Y Street, Suite 204 IT \ FAX C1 OWNER 0 OWNER -BUILDER 0 OWNER AGENT 11 CONTRACTOR 11 CONTRACTOR AGENT W ARCHITECT 11 ENGINEER 11 DEVELOPER El TENANT CONTRACTOR NAME To Be Determined LICENSE NUMBER LICENSE TYPE BUS LIC # COMPANY NAME (Competitive Bid) E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME Harlan R. Faust LICENSE NUMBER C-013474 BUS. LIC # COMPANY NAME FHA Architects E-MAIL hfaust@fhaarchitects.com FAX STREET ADDRESS 14344 Y Street, Suite 204 CITY, STATE, ZIP Omaha, Nebraska 68137 PHONE (402) 895-0878 DESCRIPTION OF WORK Tenant Improvement in new -construction building; 'fast -casual' restaurant; scope of work to include: new framing, electrical, mechanical, & plumbing, new finishes, and new equipment EXISTING USE PROPOSED USE CONSTR. TYPE 9 STORIES N/A A2 - Restaurant V -IB 1 USE TYPE OCC. SQ.Fr. VALUATION EXISM AREA NEW FLOOR AREA 1,884 DEMO AREA TOTAL NET AREA Restaurant V -B *AV16 1,884 $250,000 BATHROOM KITCHEN 01TIER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: [_J DETACH FIATTACH � DWELLING UNITS: IS A SECOND UNIT OYES SECOND STORY El - YES BEING ADDED? ONO ADDITION? F]NO PRE -APPLICATION 1­1YES IF YES, PROVIDE COPY OF IS THE BLDG AN El YES—TQT.AL_V_ALUATI0 PLANNING APPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? N By my signature below, I certify to each of the following: I am the property Owner or authoriz o property owner's behalf. I have read this �,,ndverifo'yyit application and the information I have provided is correct. I have read the Description of is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Appficant/Agent: Sean Gibbons, FHA Architects Date. 01109/15 SUPPLEMENTAL INFORMATION REQUIRED PLAN CRECK TYPE RO(ITING SLIP OVER-THF_C0VNTt1R El 0LILLOING PLAN JREVIEW N/A New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. El EXPRESS 0 PLANNING MAN REVIEW X Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 0 STANDARD PVBLlc, WORJ<S form if any Hazardous Materials are being used as part of this project. 11 LARCE El mkc oErr N/A Copy of Planning Approval Letter or Meeting with Planning prior to El mAjoit El SANITARY SEWER DJSTRICT Submittal of Building Permit application. El ENVIRONMENTAL HEALTH BldgApp.201 1.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20688 HOMESTEAD RD DATE: 01/13/2015 REVIEWED BY: MELISSA PC FEE 1D APN: 32610 066 BP #: 15O 0 'VALUATION: 1$250,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial BuildingT USE: Q—$224e-e; PENTAMATION 1 B TI PERMIT TYPE: A WORK CHIPOTLE - T.I. TO BUILD OUT NEW RESTAURANT (1,884 S.F. SCOPE $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE 1D BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 1,884 Q—$224e-e; IBTIPLNCK $1,730.24 IBTIINSP hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,730.24 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 Z2 1q,o PME Unit Fee: $0.00 TOTALS: 1,884 $ 4 $0.00 $1,730.24 MECII, HOURLY 0 Yes <D No PLUMB, HOURLY 0 Yes E) No ELEC', HOURLY ® Yes Q No u NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. Pic-)- These fees are hased on the nreliminary information available and are only an estimate. Contact the Deal for addn'l info. FEE ITEMS (Fee Resolulion II -053 Eff 7/I!/3) FEE QTY/FEE MISC ITEMS Plan Check Fee: 14,94W Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT To.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,730.24 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 _ 0 0 Work Without Permit? Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 A Strong Motion Fee. IBSEISMICO $70.00 Select an Administrative Item p Z Bldg Stds Commission Fee: IBCBSC $10.00 SUBTOTALS: $4,029$9:�: $0.00 TOTAL FEE: $4-T.o� �„ `I -Lt Revised: 01/06/2015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: i/ SUBCONTRACTOR Cabinets & Millwork�,�= BUSINESS NAME BUSINESS LICENSE # -� - Cement Finishing Electrical -° p� Excavation — - Fencinga.__..., ° Flooring / Carpeting -,m_ - _ Linoleum / Wood.... Glass / Glazing �-- Pleating ;5 Insulationw . ... Landscaping Lathing ..w. ...... Masonry ........ � Painting / Wallpaper Paving Plastering �- Plumbing Roofing Septic Tank Sheet Metal-` .. Sheet Rock Tile .. JV. 1 04c6-} a, 7 Z 3Z E Owner / Contractor Signature Date 0 X HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE i CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build inga0cupertino.org PURPOSE To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE BELOW. YES NO 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. x 2. Battery back-up rooms or racks. x 3. Propane tanks. x 4. Gasoline stations with underground tanks. x 5. Installation or replacement above ground or underground storage of liquid petroleum products, liquefied petroleum gases, compressed natural gas, explosives or other regulated hazardous materials. x 6. Gas rooms for dentist, doctors or veterinarians. x 7. Generators with back-up diesel or other fuels. x 8. Large refrigeration systems. x 9. Fuel cell systems. x 10. Commercial pool systems. x 11. Chemical Storage areas. x 12. Flammable liquid storage. X 13. Compressed Gases. x 14. Dry cleaners. x 15. Print Shops. x 16. Auto Repair and Auto Body Shops. x 17. Research and Development. x For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at (408) 378-4010. HasMat 2011. doe revised 03/07/11 454 LB Bulk CO2 Tank 450 LB Capacity Stainless Steel Cryogenic CO2 Tank The bulk CO2 system is designed to meet all of your beverage CO2 gas requirements. Technical Features • Safe, low operating pressure of 125 psi (8.6 bar) • Easy -to -read gauges for CO2 contents and tank pressure • Fully automatic system requires no electricity 20 MISC. ITEM #7 65.8 in (add 6" for legs) ......... ,,,,,,,,, ,,, „�,., ,,, .� „..., tl y atly p r , oltton �- 450 LO' uli( 4i. 2 k jDimensions Diameter 120 in 150.8 cm Height (65.8 in� i 167 cm � ' Empty Weight eig 273.... lbs 124 kg _...n Full Wei ht y 9 � 726 lbs 329 k 9 Design Criteria . Operating Pressure 1125 psig �8.6 bar 'Capacity Gross Capacity 448 gal 1182 liters 1 Liqquid Storage Capacity~ _ 453lbs j205 kg 1P,rformance Yavaporation Rate 12.5 lbs/day � 1.1 kg/day 1CO2 Delivery Rate/Cont inuous5.5 lbs/hr 2.5 kglhr eak Flow R _ Y a..te 10.0 lbs/hr i4.5 kg/hr Outdoor Fill Box Surface Mount Approximate Dimensions r1 6"x6„x2„ \ § % W Eft 2 ■� . . . . . a , ; \ �\ / �« % f ® $ / CL. k (D C-)�E\)�§/ / O 2 \ ƒ -0 q §q§ x a)' ° c / ` \ / U) 2 2 f ƒ \ / U . W (D - -- - § N % \ m O 3 2 % CO Z w w w a 9 C A R � k ƒ »L \ I § G IV, % � 2 PEB-NF (NUFLEX) POLYETHYLENE BEVERAGE HOSE Hose is made from premium grade FDA and NSF -51 listed materials. The combination of the EVA cover and the Polyethylene tube material have been carefully selected for low taste and odor properties, superior flexibility, clarity and high environmental stress cracking resistance. Applications: • Soft drink fountain machines for retail and commercial dispensing • Other beverage dispensing to include but not limited to the following o Coffee and coffee related products, fruit juice, frozen drinks, ice tea, • Fruit juice, ice tea, coffee and coffee related product dip • Water service (potable) both carbonated and non -carbonated • Dairy product dispensing machines o Milk, frozen dairy products, hot cheese, cream and imitation milk products • Food product distribution and dispensing o Condiments, food powders, liquid toppings • Draught beer, wine and liquor distribution and dispensing systems Features: • Low taste and odor, smooth bore tube for excellent flush -ability, product changes and clean-out. • Light -weight, flexible, kink resistant & non -marking • Good low and high temperature properties including high environmental stress crack resistance characteristics. • Designed for easy coiling, assembling and installation • Spiral reinforced for extended service life. • Good clarity for product and cleanliness inspection while in use. Supersedes 2/27/13 Revised 3/21/13 Construction: • Tube: extruded from FDA approved (regulation 21 CFR 177.1520) and NSF -51 listed Polyethylene. Material has been carefully selected for its low taste and odor properties, superior flexibility, clarity and high environmental stress cracking resistance. o LDPE chemical resistance to CO2 (wet/dry) is rated an A up to 70°F and an A/B up to 140°F • Reinforcement: Synthetic, high tensile textile cord for improved coupling retention, higher pressure ratings and longer lasting overall product integrity and durability • Cover: FDA approved (regulations 21 CFR 177.1350 and 175.105) Ethylene Vinyl Acetate (EVA) Copolymer specially formulated for clarity and added flexibility o EVA chemical resistance to CO2 (wet/dry) is rated an A up to 70°F • All materials used in the construction of this product are RoHS compliant. Print Sequence: NUFLEX (20608 or 20623) (ID from table)" ID X (of) from table) OD MAX TEMP 159 F BEVERAGE HOSE MADE FROM FDA/NSF-51 MATERIALS (date code) Specifications: Temperature Range: -40°F (-40°C) to 150°F (65.5°C) Standard Sizes: 1/4", 3/8", 1/2" Rated Working Pressure: See Table Below Packaging: 300' or 500' bulk cardboard spools boxed for redistribution Item Number ; , UVT. Per Ft. Standard Plcrg oty IaD o t?, is @ 70"F Factor p PEB NF04CC 00(20608) i 1/4 1 0.420 j 300 PSl 4:1 .035 lbs I 500 ft boxed or reels PEB NF06CC 00 (20623) 3i$ { 0 535 ;P 300 PSI 4.1 1 .047 lbs 300 ft boxed or mels Supersedes 2/27/13 Revised 3/21/13 CO2 VENT HOSE 1413N -08X500 "A FLEXIBLE LOW TEMPERATURE HOSE, DESIGNED FOR USE WITH COMPRESSION AND PUSH -TO -LOCK FITTINGS TO VENT EXCESS CARBON DIOXIDE GAS FROM BULK STORAGE SYSTEMS" 60 SHORE D CO -POLYESTER 60 SHORE D BLACK CO -POLYESTER SEAMLESS EXTRUDED POLYESTER YARN WEATHER -RESISTANT CORE TUBE REINFORCEMENT EXTRUDED JACKET Dimensions: I.D. = 0.375" +/- 0.006" O.D. = 0.500" +/- 0.006" Pressure Capabilities: - MAX. 300 PSIG WP @ 70F - MIN. 1200 PSIG BURST @ 70F Packaging_ 500 Foot Cardboard Spools/Boxed Material Performance: The co -polyester material, similar to that used in DOT 106 air brake hose, offers a superior service temperature range and longer service life to that provided by traditional nylon tubing. Service Temperature Range: -109.3°F (-78°C) to +200°F (+93°C) This hose has been bent under laboratory conditions at -109.3°F (-78°C) without cracking Branding: White ink repeated every 3 feet: CO2 VENT HOSE 3/8" ID 300 PSI WP AT 70F 1200 PSI MIN BP USE NUCO2 P/N 744138 TUBE SUPPORT WITH COMP FITTINGS CANADA date code TECHNICAL SHEET ACCUFLEX INDUSTRIAL HOSE LTD. v MANUFACTURERS OF HOSE AND TUBING DRAWN BY: C. BENDER DRAWING SERIES: DATE: JUL. 18, 2013 1413N 4� N m m n 0 a3 Li N I w 03 E V ID 0 0 m --t nEE E :3 Li )� It I� � \ � N m -T m w W a co Segno ACOA #3521 Seating with Stye' Fumiture Item #18 Segno ADA #3521 ev cie r #3571 2y%' as Item #3521 Patented Outdoor/Indoor ADA Table Legs: Square Tubular Steel Top: Steel Finish: See Price List Feet: Plastic, with Adjustable Footcaps Weight Each: 36.5 Lbs, Units Per Box: 1 Box Volume: 4.5 Cubic Ft. Assembly Required Segno # 851, #852 Segno # 850, #853 Design: CR MIA emuamericas LLC 0 T:(800) 726-0368 F: (800) 970-7708 em U www.emuamericas.com 00 1 I I N I I P I Z*UM slNl O I . 8 I ? I I � I I I GM S9 tf — I . I iI SF I S I 70 IIIIIIII 1QoMY b IIIIIIII 0 IIIIIIII a 1 I I N I I P I O I . I ? I I � I I I GM S9 tf — I . I iI SF I S I Cc eCc _v ; a� C/o CD Z Z a OC � W Z W W Q m C ;l W C= m Z O = 0 had �aS S4O 11111111 �IIIIII_I. IIIIIIII - IIIIIIII IIIIIIII G-Rozo . " 'IIIIIIII IIIIIIII �� IIIIIIII IIIIIIII �cm im Pol"a wt - ---- ------ IN, - --------- - -1.1.1 .\\ saipnj WrJ .—N ml.dNo in *0004M T=- MgVLOzOl CWZ/61/6'6ffiPgulglsDd=Dsing lsodwoo\ELOn4OO8\3-IiOdIHO\OSVISBUIMW(]\:r Lockers Standard Features & Benefits ♦ Ships setup and ready to use ♦ Locker sizes for all your needs ♦ Heavy duty construction - 16 ga. door and frame ♦ Powder coated finish out lasts other finishes ♦ Standard finish is beige ♦ Available in 12", 15", and 18" depths EL -1 EL -2 EL -3 "A MISC. ITEM #30 Model: EU EL2 EU EU EL5 EL6 d EL16 EL-VwGarment Bar EL-5/STI EL -6 EL -16 Website: www.kelmax.com Job Name: Qty:_ Item: 0 N �D 00 O � 00 C.a O p 'y 00 00 a � 00 00 f7 O id A W O p � O tJ W �D W W 0 6/03 Specifications: BODY. - 16 gauge door and frame, rear legs, lock clips. 20 gauge top, bottom, shelves, back, filler, and slope top components. 24 gauge sides. HINGES: Continuous hinge Padlock hasps standard on all units for positive locking. Single and double tier are standard with double ceiling hook and 2 side hooks. Single tier units have hat shelf 12" from top. 15 & 16 person units include 4' hanger bar. LEGS: All units standard with 6" legs; also available without legs. Options: 15" 3 /STI Slope top one wide EL3/18 EL39/18 12" HIGH DOORS /ST2 Slope top three wide 18x12x78 /ST3 Slope top four wide 12" /BASE] Enclosed base one wide 78 /BASE3 Enclosed base three wide 5 /GANG2 For 2 unit lockers together ELS/18 EL515/18 12" HIGH DOORS 18" MISC. ITEM #30 PER COLUMN 1 3I a OF DIM(DxWxH) WGT I a OF DIM(DxWxH) WGT COLUMN COLUMN DEPTH DOORS IN LB MODEL DEPTH DOORS IN LB ort U11 -U nnnD 12" HIGH DOORS 36" HIGH DOORS 12" H/GH DOORS EL2/15 EL26/15, 15" 2 15xl2x78 74 EL16/15* IS" 16 15x69x78 213 EL2/18 EL26/18 18" 2 18xl2x78 78 EL16/18* 18" 16 1 18x69x78 213 24" H/GH DOORS EL -3/15 EL39/15 15" 3 15x 1208 78 EL3/18 EL39/18 12" HIGH DOORS 18" 3 18x12x78 80 ELS EL515 12" 5 12x 12x66 78 EL5/15 jj E1,515/15 IS" 5 I5xl2x66 84 ELS/18 EL515/18 12" HIGH DOORS 18" 5 18x12x66 88 EL6 EL618 12" 6 12xl2x78 78 EL6/15 EL618/15 15" 6 15x 1208 85 EL6/18 EL618/18 18" 6 18xl2x78 88 AEzffmo ' Equipment 814 Jordan Ln. Decatur, GA 30033 404-296-9080 1-800-810-9080 Fax: 404-296-3040 www.kelmax.com SPECIFICATIONS DESCRIPTION: Well mount PAR20 accent fixture. Suitable for woVdamp/dry location Installations, MATERIAL: Standard overall material Is 6061 aluminum. HL -374 - Machined Aluminum FINISH: AA - Anodized Aluminum AP . Powder Coat Aluminum BK- Powder Coat Bleck BZ - Powder Coat Bronze WT - Powder Coat White LAMPING: Lamp Type - 120V Incandescent PAR20 lamp, medium base, 50W max, not included. VOLTAGE: 120. 120 VAC, MOUNTING: Fixture Is aulpped with a 4.75" mounting P late end (2� mounting screws, OPTIONS: Glare shields GL -21 - Angled, aluminum GL -23 - Stralgght, aluminum Lenses/Louvers/Color Filters LA -1.20 - Hexcell Louver (Black) LA -2.20 - Prismatic lens LA -3.20 - Linear spread lens LA4.20 - Soft focus lens (diffused) LA -5.20 - Moonlight lens LA -6.20 - Blue lens See fixture accessories for more information. SAMPLE ORDER SPECIFICATION: HL -374 -AA -120 -LA -3-20 RATING: Wet/damp/dry location, IG. Intertek MADE IN THE USA ORDER SPECIFICATION: PROJECT: APPROVED: NOTE: TYPE: 04 3/4" (1211 Fixture Finish 02 3/4" [691 3 13/16" ,f [97] — 5 3/4" [1 71 mping Voltage Options/Access. Q HEVI LITE, INC. 9714 Variel Ave, Chatsworth, CA 91311 Tei., (818) 341-8091 - Fax (818) 998-1986 Web Site http://www.hevilite.com CATALOG NUMBER: HL -374 THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPERTY OF HEVI LITE. INC. ANY REPRODUCTION IN PART OR WHOLE WITHOUT THE WRITTEN PERMISSION OF HEVI LITE, INC. IS PROHIBITED. SPECIFICATIONS DESCRIPTION: Specification grade PAR20 adjustable accent fixture, Suitable for wet/damp/dry location Installations, MATERIAL: Standard overall material Is 8061 aluminum, HL -370 -, Machined Aluminum FINISH: AA - Anodizod Satin Aluminum AP - Powder Coat Aluminum BK Powder Coat Black BZ - Powder Coat Bronze WT - Powder Coat White LAMPING: Lamp Type - 120V Incandescent PAR20 lamp, medium base, 50W max, not Included, VOLTAGE: 120 - 120 VAC, MOUNTING: Fixture Is designed with a 1/2 -NPS adjustable mounting stem, OPTIONS: Glare shields GL -21 - Angled, aluminum GL -23 - Straigght, aluminum Lenses/Louvers/Color Filters LA -1-20 - Hexcell Louver (Black) LA -2-20 - Prismatic lens LA -3.20 - Linear spread lens LA -4.20 - Soft focus lens (diffused) LA -5.20 - Moonlight lens LA -6.20 - Blue lens See fixture accessories for more Information, SAMPLE ORDER SPECIFICATION: HL -370 -AA -120 -GL -23 -LA -4-20 RATING: Wet/damp/dry location, .G.us Intertek MADE IN THE USA 2 1/8" [541 0 ORDER SPECIFICATION: Fixture Finish PROJECT: APPROVED: NOTE: TYPE: �02 3/4" [691 6 5/8" a [169] 3 7/8" [981 Q HEVI LITE, INC. 9714 Variel Ave, Chatsworth, CA 91311 Tel., (818) 341-8091 - Fax (818) 998-1986 Web Site http://www.hevilite.com CATALOG NUMBER: HL -370 THE INFORMATION CONTAINED IN TWS DRAWING IS THE SOLE PROPERTY OF NEVI LITE, INC. ANY REPRODUCTION IN PART OR WHOLE WITHOUT THE WRITTEN PERMISSION OF NEVI LITE, INC, IS PROHIBITED. SPECIFICATIONS DESCRIPTION: Cast ground mounling s lke with wiring cor�partrnent, for low voltage applicatlons. Suitably for wet location Installations, MATERIAL, Standard overall material is cast aluminum, GM -8 - Cost Aluminum FINISH: SK - Powder Coat Slack VOLTAGE: Wiring compartment Is designed for low voltage (12V) fixtures, MOUNTING: Spike has (1) 1/2 -NPS mount, SAMPLE ORDER SPECIFICATION: GM -t3 -BK RATING: Wet/damp/dry location, MADE IN THE USA ORDER SPECIFICATION: Fixture Finish PROJECT: APPROVED: NOTE: TYPE: RI 1/A" [31.x6) I /7-Np5 23/16' [ 55.961 Q HEVI LITE, INC. 9714 Variel Ave, Chatsworth, CA 91311 Tel., (818) 341-8091 - Fax (818) 998-1986 Web Site http:/twww.hevilite.com CATALOG NUMBER: GM -6 THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPERTY OF HEVI LITE, INC. ANY REPRODUCTION IN PART OR WHOLE WITHOUT THE WRITTEN PERMISSION OF HEVI LITE, INC. IS PROHIBITED. 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Toll Free USA/Canada (415) 292-5400 (415) 292-5410 Fax w�.�,U"sLti�t#.7tc6Al�l�:S�IS1 jr�! infohitrashmanage.com Homestead Square Cupertino, CA Trash Management Plan Goal: Design a waste and recycling system for this retail development that provides sufficient waste and recycling disposal services to meet both tenant needs and City of Cupertino requirements. Waste and Recycling: The City of Cupertino has granted an exclusive franchise for waste and recycling removal for any property located within the city limits to Recology. Recology provides waste, commingled recycling and compost collection. Waste rates were increased November 1, 2013 and remain in effect until the end of October, 2014. Dry recycling is free. This includes paper products, glass and plastic. Only food waste recycling ("composted") is done on a fee basis. Compacted disposal is less expensive than loose disposal. The implicit $ per Ib. for a roll -off compactor is 39% less than standard fron load service. Specific Development Characteristics: Homestead Square is a high-end retail development. 89% of the retail space is occupied by 6 major tenants: Safeway (supermarket), Stein Mart (upscale boutique), Ross (moderately - priced clothing store), Michaels (arts and crafts store), Rite Aid (pharmacy) and Chase (bank). (A seventh major tenant will be added in the future.) The remainder are small retailers. With the exception of Safeway -- which aggressively backhauls and recycles al l trash -- the other retailers are priimarily dry waste generators with a minimal amount of wet garbage. State and Local Recycling Mandates: Statewide the passage ofAB341 (July Ist, 2012) required all business that generate more than 4 cubic yards of municipal solid waste to recycle, and directed local jurisdictions to implement recycling regulations and programs. Consistent with State law, Cupertino has implemented a mandatory recycling program for all commercial developments and it provides strong incentives to divert materials from the landfill by offering free pickup of recyclables. Current Waste and Recycling Systems in Place at Homestead: Telephone surveys of three major tenants yielded the following information about current waste and recycling levels at Homestead. Safeway. Safeway has one of the most aggressive waste diversion programs in the supermarket industry, with a goals of zero wastes (materials to landfill). To that end, it self hauls to its Distribution Center (DC) nearly all recyclable materials including cardboard, waxed cardboard, organics (compost), plastics and all containers.. It uses a vertical compactor to handle the remaining non -recyclable materials (broken glass, dirty plastics), which is emptied on a 6x per week schedule. State and City regualtions (6.24.035(C) of the Cupertino Municipal Code) mandate businesses generating an amount of waste greater than or equal to 4 cubic yards are required to recycle. Regarding containers, Roger Vanderwende, the manager of al Safeway's recycling programs, confirms that Safeway recycles ridged plastic including plastic bottles that would include things like cooking oils. Safeway generates less than 2lbs of glass per day in just one department and we have a recycling program for that glass. Safeway does not generate any aluminum cans. © American Trash Management, Inc. Page I of 7 Tuesday, December 2, 2014 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Tol I Free USA/Canada (415)292-5400 (415)292-5410 Fax kV_WA)L,tdkL`shJ: AJ1r9."�Z,.QQM . nage. Com Pursuant to Section 6.24.035(C) of the Cupertino Municipal Code and State law (AB 341), commercial businesses generating greater than or equal to four cubic yards of refuse per week are required to subscribe to mandatory recycling services. Back -haul of all recyclables by the generator, meets this requirement and as such, staff accepts Safeway's self -haul recycling program. If however, during periodic waste audits of the compacted garbage it is determined that an unreasonable amount of recyclables are comingled, the City will require placement of a free recycling bin within an enclosure on the property for use by Safeway. Since 2008, the City has required all businesses that receive a permit for tenant improvements to provide a trash enclosure with a roof for disposal bins and compactors. The requirements are given to all project applicants and are accessible on the City's website. The project applicant assumed that Safeway's self-contained compactor would be exempt from this trash enclosure requirement. The City encouraged the property owner to provide a trash enclosure for the compactor, but did not require one at the time of building permit approval. If however, stormwater related violations (such as uncontained outdoor garbage, or spills from the compactor) are observed, new construction or shared use of a nearby enclosure will be required [9.18.210(H)(2) CMCJ To account for Safeway's self -haul recycling, the City requests an estimated amount of material recycled from the Cupertino Safeway for inclusion in the City's annual report to the State (CalRecycle). This data will aid in demonstrating the City's reporting accuracy and compliance with State law. RiteAid. RiteAid is a relatively low generator of trash. It currently has two dedicated 4 -cubic yard dumpsters, one for waste (picked up 1 x per week) and a second for comingled recyclables (2x/week service.) A 96 -gallon Toter can be added for food wastes if tenant elects to do so. Michaels. A high percentage of Michaels' trash is cardboard, which they dispose of in a compactor with a 40 -cubic yard receiver container, emptied on an as -need basis. Michaels also has a dumpster serviced weekly for waste. A 96 -gallon Toter can be added for food wastes if tenant elects to do so. Projected Waste and Recycling Levels: Standard Retail Tenants. CalRecycle research (Waste Disposal and Diversion Findings for Selected Industry Groups, 2006) estimated 9.6416. of materials generated per day per 1000 SF of space by retail anchor tenants (with similar trash profiles as Michaels, Stein Mart and Ross). Of this amount, 40% was diverted and an additional 33% was "easily" [19%] or "potentially" [14%] divertable. ATM's database of similar retail anchor tenants found a 3 lb. per day per 1000 SF post diversion. Assuming greater diversion rates today vs. 2006 (that all of the easily diverted material and 1/2 of the potentially diverted material are now not being landfilled) one arrives at similar numbers as those of the CalRecycle study. 11lsilke ll i % oj`dvirall inAttrials # per 000 Sly' pear day Landfilled 33% 3.00 Ib. per day Diverted 66% 6.00 Ib. per day Total 99% 9.00 Ib. per day These numbers are consistent with the CalRecycle study and will be used in this analysis. It will be assumed 1/3 of all materials are now landfilled (3 lb. per 1000 SF) and 2/3s are recycled (6 Ib. per 1000 SF). This 1:2 ratio is also consistent with what Rite Aid is generating although it is lower than what either Safeway (90%+ diversion rate) or Michaels has acheived. American Trash Management, Inc. Page 2 of 7 Tuesday, December 2, 2014 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Toll Free USA/Canada (415) 292-5400 (415) 292-5410 Fax Projected Waste and Recycling Levels: Small Restaurants and Cafes, Using CalRecycle research (Waste Disposal and Diversion Findings for Selected Industry Groups, 2006), company -provided per store sales information and industry metrics for employment levels and waste generation, the following projections of waste levels for the three restaurants. PAD 4 Store AY - 0 S Waste,' �­"R, cling �CY/Week) Waste Service, Orylkecyeflng Compost Chipotle $656,225 5.49 8.24 (2) 96 -GAL 6x (2) 96 -GAL 5x (2) 64 -GAL 5x Noah's $664,233 5.56 8.34 (2) 96 -GAL 6x (2) 96 -GAL 5x (2) 64 -GAL 5x Great Clips $275,000 0.48 0.12 (1) 96 -GAL I x (1) 96 -GAL I x N/A PAD 5 stoke ASC "tore;` Sales' este ReeYtIl'"g, WitsteServii Compost Pizza $650,000 5.44 8.16 (2) 96 -GAL 6x (2) 96 -GAL 5x (2) 64 -GAL 5x Burger $650,000 5.44 8.16 1 (2) 96 -GAL 6x (2) 96 -GAL 5x (2) 64 -GAL 5x Starbucks $1,019,000 8.53 12.79 1 (3) 96 -GAL 6x (3) 96 -GAL 6x (2) 64 -GAL 6x Trash Enclosures- There are 8 individual trash enclosures, all 12' deep x 23' wide, capable of holding several front load bins and/or 96 -gallon carts. 0 American Trash Management, Inc. Page 3 of 7 Tuesday, December 2, 2014 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Toll Free USA/Canada A, (415)292-5400 (415) 292-5410 Fax i�V � aslmana= Mml 11��1A pl * 1nf062trachmaaaz>'- om TRASH ENCLOSURE LAYOUTS Starbucks, Burger and Pizza Restaurants Trash Enclosure I 23.239 3.058 12.009 ; for wastes for compost. 4.054 23.239 ; © American Trash Management, Inc. Page 4 of 7 Tuesday, December 2, 2014 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Toll Free USA/Canada (415)292-5400 (415) 292-5410 Fax Trollph -W-Awnsfu winw,.om me I""" WfaLCut d:,bMj ace com TRASH ENCLOSURE MAP - I1 0,I'l L u �� ,,, ✓� ii„ i� /� / r ////�/ /� „ ii% .,,/ii�„�� Near Rite Aid Rite Aid 18203 3.82 7.65 Actual service = 4 CY and 8 CY per week. Adequate Space Pad 3 Chase 5440 1.14 2.28 Assume (2) 2 CY Ix/week (waste) and 2x/ eek (recycling). Adequate Space Pad 4 Great Clips 6859 11.50 16.70 Two small restaurants and one small retailer hipotle with (8) 96 -GAL carts for waste & mixed Noah's ecyclables; (4) 64 -GAL carts for compost. Adequate space ad 5 Starbucks 6116 19.41 29.11 14) 96 -GAL carts for waste and mixed Burger & recyclables + (6) 64 -GAL carts for compost Pizza serviced 5x and 6x per week will provide sufficient service. Total cart footprint = 150SF, adequate space enclosure = 276 SF Ross, Michales oss 25094 5.27 10.54 (1) 3-CY 2x waste and (1) 4-CY 3x for & FedEx recylcing. Adequate space Ross, Michales ichaels 21066 4.42 8.85 1) 4-CY ]x. Recycling goes into the & FedEx compactor. Adequate space. Ross, Michales edEx 5790 1.22 2.43 (3) carts -- (2) 96 + (1) 64 -GAL -- for waste, FedEx I I I I precycling& compost. Adequate space. © American Trash Management, Inc. Page 5 of 7 Tuesday, December 2, 2014 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Toll Free USA/Canada (415) 292-5400 (415) 292-5410 Fax infa4mashmanage corn Ross, Michaels and FedEx. The drawing above indicates there is sufficient space for two dedicated Ross dumpsters (waste and recycling), one dumpster for Michaels' waste, three 96 -gallon carts for FedEx waste and recycling in a single enclosure and three 64 -gallon carts for compost, one per user. Starbucks, Pizza Restaurant and Burger Restaurant. The drawing above indicates there is sufficient space for 20 96 -gallon carts to provide waste, recycling and compost services. These will be picked up 5x or 6x per week as needed. The footprint of a 96 -GAL cart is 3'x 2.5'= 7.5 SF. Total cart space = 20 x 7.5 SF - 150SF. The enclosure is 12' x 12'= 276SE This should leave ample space in the enclosure for accessing the carts. Stein Mart. The bulk of Stein Mart's materials will be rcycled in a stationary compactor with a roll -off receiver container. For the minimal wastes and compost that will be produced at the site, it is recommended that two carts -- (1) 96 -gallon for wastes and (1) 64 -gallon for compost -- be placed at the end of the compactor enclosure for pickup by Recology. When the 40-CY receiver container is to be serviced, the carts can be easily moved aside. Compaction for Enclosures Servicing Multiple Tenants. An individual front -load compactor could provide service for multiple tenants (Starbucks, pizza and burger restaurants for example) using less space than carts. However, going to a common compactor relieves the individual business of the cost and responsibilties for their wastes and recycling. The strongest incentive to divert is put the onus of paying for waste disposal on the individual tenants. Therefore, using carts is recommended over a common -usage compactor. "fallow Bins. It will be recommended that the small restaurants doing cooking maintain a tallow bin in their premises. ANCILLARY ISSUES Truck Traffic. All truck deliveries, pickups and other traffic to the development will adhere to all applicable traffic and noise ordinances, specifically those applying to afterhours deliveries and pickups: 10.48.062 Nighttime Deliveries and Pickups. It is unlawful and a nuisance for any person to make or allow vehicular deliveries or pickups to or from commercial establishments (defined as any store, factory, manufacturing, or industrial 0 American Trash Management, Inc. Page 6 of 7 Tuesday, December 2, 2014 �,���r,///� ����/ - i�o, � ,�� //„i,/� „ / ; - ,i,i � /✓,i,-iGi . /i�, /iii � /,, ,, .,,... � i , �i � ,,� ,, i��r^i�, , ;, , .,, ,.., ,., // iii%,��i/%/,�/�, � �� ��� � i/�� ,✓i/ � ,,i/viii r , � ,,,,,, . Safeway Safeway 54984 N/A N/A Safeway diverts and backhauls to its DC 90% of its materials. Uses a 3-CY vertical compactor emptied 6x per week. Footprint = x 8'. Ad uate space. Stein Mart Stein Mart 31449 6.60 13.21 Stein Mart projects using a compactor for recycling. A 96 -GAL cart for waste + 64 - GAL cart for compost 4X per week will provide sufficient service. These will be set in the compactor enclsoure at the end of the container and moved aside when the 40-CY roll -off recycling container is serviced. lta and 2nd Ulta and 23601 4.96 9.91 Ulta will have (1) 2-CY dumpster for waste Retailer another and (1) 2-CY dumpster for recycling. It is retailer projected this will be the service for the second retailer. Overall footprint of containers= 78 SF. Trash enclosure= 16' w 18'd = 288 SF. Sufficient room for the um sters. Ross, Michaels and FedEx. The drawing above indicates there is sufficient space for two dedicated Ross dumpsters (waste and recycling), one dumpster for Michaels' waste, three 96 -gallon carts for FedEx waste and recycling in a single enclosure and three 64 -gallon carts for compost, one per user. Starbucks, Pizza Restaurant and Burger Restaurant. The drawing above indicates there is sufficient space for 20 96 -gallon carts to provide waste, recycling and compost services. These will be picked up 5x or 6x per week as needed. The footprint of a 96 -GAL cart is 3'x 2.5'= 7.5 SF. Total cart space = 20 x 7.5 SF - 150SF. The enclosure is 12' x 12'= 276SE This should leave ample space in the enclosure for accessing the carts. Stein Mart. The bulk of Stein Mart's materials will be rcycled in a stationary compactor with a roll -off receiver container. For the minimal wastes and compost that will be produced at the site, it is recommended that two carts -- (1) 96 -gallon for wastes and (1) 64 -gallon for compost -- be placed at the end of the compactor enclosure for pickup by Recology. When the 40-CY receiver container is to be serviced, the carts can be easily moved aside. Compaction for Enclosures Servicing Multiple Tenants. An individual front -load compactor could provide service for multiple tenants (Starbucks, pizza and burger restaurants for example) using less space than carts. However, going to a common compactor relieves the individual business of the cost and responsibilties for their wastes and recycling. The strongest incentive to divert is put the onus of paying for waste disposal on the individual tenants. Therefore, using carts is recommended over a common -usage compactor. "fallow Bins. It will be recommended that the small restaurants doing cooking maintain a tallow bin in their premises. ANCILLARY ISSUES Truck Traffic. All truck deliveries, pickups and other traffic to the development will adhere to all applicable traffic and noise ordinances, specifically those applying to afterhours deliveries and pickups: 10.48.062 Nighttime Deliveries and Pickups. It is unlawful and a nuisance for any person to make or allow vehicular deliveries or pickups to or from commercial establishments (defined as any store, factory, manufacturing, or industrial 0 American Trash Management, Inc. Page 6 of 7 Tuesday, December 2, 2014 1900 Powell Street, Suite 890 Emeryville, CA 94608 (800) 488-7274 Toll Free USA/Canada AL (415) 292-5400 ti�A (415) 292-5410 Fax inLlj rashmanaue corn plant used for the sale, manufacturing, fabrication, assembly or storage of goods, wares and merchandise) by the use of private roads, alleys or other ways located on either side or the back of any building housing the commercial establishment where such private road, alley or other way lies between the building and any adjacent parcel of land zoned for residential purposes, between the hours of eight p.m. and eight a.m. weekdays (Monday through Friday) and six p.m. and nine a.m. on weekends (Saturday and Sunday) and holidays except as may be permitted under Section 10.48.029. (Ord. 1871, (part), 200 1) �tl ; Property management will be responsible for common -area cleanup. General sweeping and related clean-up activiities will be conducted R per week, and a portering service for collecting materials will be scheduled at least 4x per week. To best of management's ability, the property will be maintainted litter -free. Encouraging trash best practices. °fenants will be encouraged to engage in trash -related best practicTs, which includes segmenting as attach Cas possible, all divertibl 9 materials in the recycling and compost containers and using clear plastic bas to collect materials, t Cl.pptltp11l1,t 1,., ak '"l he "11'ash C�;nclosure near Pad 1 is designated for coninton area wastes, Currently it will has two 4-Ci'Y bins (52 SF footprint for bath) used by Ritc-Aid. fbis leaves over 2001 SF of space for two additional waste and recycling bins for the common area waste and mixed recyclables. At sonic future date, management may consider adding three small recepticles for waste, rccyclables and compost for public use at Pad 4. © American Trash Management, Inc. Page 7 of 7 Tuesday, December 2, 2014 �A��?6 itr I�I�II f ,III �I re Cl' tl I14 h H d d0 E h V tS t W t L po e i c en U an rease x aunt en ys em a C ea k Test Report (A form roust be completed for each da of testing and faxed within 3 days of test) Date: �- nviromatic ork Order #:� Chipotle Store 4 _ S Locatio Address: r (i State: Pte. a°6�ff �Wrn" d cvQe{ C- e9 4LS01� If test is going to exceed $750.00 Don or Brittany at Enviromatic must be contacted immediately while crew is stili at the job site 800-325-8476. 1) Amount of leak testing done (Circle One) Complet or Partial system tested. (Brittany and Don at Enviromatic must be informed imm ' testing is partial, one form for each day) a) If partial system — please describe what section(s) completed at this time: 2) Initial test results (Circle on) —Leaks found in system: YES' or NO a) If Yes; please list how ma leaks were found an oc tign of leaks. L 1) Number found: Location of leaks- �'towu ea6-p rt/ b) If Yes. how many times was retesting of system required 47 - c) If Yes, how much extra time was required for the retesting- Y hours d) Were you required to come back additional day? YES �i'E) agach additional form ) 3) Please show diagram of the grease exhaust system showing access locations and locations of leaks found. You may use aqd attach additional sheets) if needed. i to �s 9 Aodr aa4s 4) Tested an t he tested section of the grease exhaust vent system (circle one) DOES OES NOTJeak after fi 1 high pressure water testing o this d Test company roval (Name) C7 Signature Site Superintendent approval (Name) �! ignature . Please e -email completed digital pictures of entire system to info @ rvt atic.com MUST FAX COMPLETED FORM TO 877-325-8476 OR 612-861-5578 * "Please list any other issues with system below or on separate sheet that you feel needs to be brought up to the Construction and/or Facilities department. Ot It L Lei 5 e- F�