[BSC] Sample forms found in “A Guide to the California Green Building Standards Code (Nonresidential)” located at http://www.bsc.ca.gov/Home/CALGreen.aspx may be used to assist in documenting compliance with the waste management plan and other provisions of this code.

[HCD 1] Sample forms located at www.hcd.ca.gov/CALGreen.html may be used to assist in documenting compliance with CALGreen.

WORKSHEET (WS-1)
BASELINE WATER USE
BASELINE WATER USE CALCULATION TABLE
FIXTURE TYPEFLOW RATEDURATIONDAILY USESOCCUPANTS1GALLONS PER DAY
Showerheads2.0 gpm @ 80 psiX5 min.X1XNote 1a=
Lavatory faucets nonresidential0.5 gpm @ 60 psiX.25 min.X3X=
Kitchen faucets1.8 gpm @ 60 psiX4 min.X1XNote 1b=
Replacement aerators2.2 gpmXXX=
Wash fountains1.8 gpm/20 [rim space(in.)@ 60 psi]XXX=
Metering faucets0.20 gal/cycleXX3X=
Metering faucets for wash fountains0.20 gal/cycle/20 [rim space(in.)@ 60 psi]X.25 min.XX=
Gravity tank-type water closets1.28 gal/flushX1 flushX1 male2 3 femaleX=
Flushometer tank water closets1.28 gal/flushX1 flushX1 male2 3 femaleX=
Flushometer valve water closets1.28 gal/flushX1 flushX1 male2 3 femaleX=
Electromechanical hydraulic water closets1.28 gal/flushX1 flushX1 male2 3 femaleX=
Urinals0.5 or 0.1253 gal/flushX1 flushX2 maleX=
Total daily baseline water use (BWU)=
  1. _small_top_bottom_padding">For nonresidential occupancies, refer to Table A, Chapter 4, 2016 California Plumbing Code, for occupant load factors.

    1. Shower use by occupants depends on the type of use of a building or portion of a building, e.g., total occupant load for a health club, but only a fraction of the occupants in an office building as determined by the anticipated number of users.
    2. Kitchen faucet use is determined by the occupant load of the area served by the fixture.
  2. The daily use number shall be increased to three if urinals are not installed in the room.
  3. Floor-mounted urinals @ 0.5 GPF or wall-mounted urinals @ 0.125 GPF.
WORKSHEET (WS-2) WATER USE REDUCTION
12-, 20- 25-PERCENT REDUCTION WATER USE CALCULATION TABLE
FIXTURE TYPEFLOW RATEDURATIONDAILY USESOCCUPANTS1GALLONS PER DAY
ShowerheadsX5 min.X1XNote 1a=
Lavatory faucets nonresidential4X.25 min.X3X=
Kitchen faucetsX4 min.X1XNote 1b=
Replacement aeratorsXXX=
Wash fountainsXXX=
Metering faucetsX.25 min.X3X=
Metering faucets for wash fountainsX.25 min.XX=
Gravity tank-type water closetsX1 flushX1 male3 3 femaleX=
Flushometer tank water closetsX1 flushX1 male3 3 femaleX=
Flushometer valve water closetsX1 flushX1 male3 3 femaleX=
Electromechanical hydraulic water closetsX1 flushX1 male3 3 femaleX=
UrinalsX1 flushX2 maleX=
Urinals Nonwater supplied0.0 gal/flush1 flush2 maleX
Proposed water use=
12% Reduction ________ (BWU from WS-1) X .88 = ________ Allowable water use
20% Reduction ________ (BWU from WS-1) X .80 = ________ Allowable water use
25% Reduction ________ (BWU from WS-1) X .75 = ________ Allowable water use
<div class="uc_small_text_note">
  1. For occupancies, refer to Table A, Chapter 4, 2016 California Plumbing Code, for occupant load factors.

    1. Shower use by occupants depends on the type of use of a building or portion of a building, e.g., total occupant load for a health club, but only a fraction of the occupants in an office building as determined by the anticipated number of users.
    2. Kitchen faucet use is determined by the occupant load of the area served by the fixture.
  2. Includes single and dual flush water closets with an effective flush of 1.28 gallons or less.

    Single flush toilets - The effective flush volume shall not exceed 1.28 gallons (4.8 liters). The effective flush volume is the average flush volume when tested in accordance with ASME A112.19.2.

    Dual flush toilets - The effective flush volume shall not exceed 1.28 gallons (4.8 liters). The effective flush volume is defined as the composite, average flush volume of two reduced flushes and one full flush. Flush volumes will be tested in accordance with ASME A112.19.2 and ASME A112.19.14.

  3. The daily use number shall be increased to three if urinals are not installed in the room.
  4. Where complying faucets are unavailable, aerators rated at 35 gpm or other means may be used to achieve reduction.


Title 23, Waters, California Code of Regulations
APPENDIX D
Prescriptive Compliance Option


Note: This sample form may be used to assist in documenting compliance with the waste management plan.

Project Name: ___________________________________________________

Job #: __________________________________________________________

Project Manager: _________________________________________________

Waste Hauling Company: __________________________________________

Contact Name: _________________________________________________

All Subcontractors shall comply with the project’s Construction Waste Management Plan.

All Subcontractor foremen shall sign the CWM Plan Acknowledgment Sheet.

Subcontractors who fail to comply with the Waste Management Plan will be subject to backcharges or withholding of payment, as deemed appropriate. For instance, Subcontractors who contaminate debris boxes that have been designated for a single material type will be subject to backcharge or withheld payment, as deemed appropriate.

  1. The project’s overall rate of waste diversion will be ____%.
  2. This project shall generate the least amount of waste possible by planning and ordering carefully, following all proper storage and handling procedures to reduce broken and damaged materials and reusing materials whenever possible. The majority of the waste that is generated on this jobsite will be diverted from the landfill and recycled for other use.
  3. Spreadsheet 1, enclosed, identifies the waste materials that will be generated on this project, the diversion strategy for each waste type and the anticipated diversion rate.
  4. Waste prevention and recycling activities will be discussed at the beginning of weekly subcontractor meetings. As each new subcon-tractor comes on-site, the WMP Coordinator will present him/her with a copy of the CWM Plan and provide a tour of the jobsite to identify materials to be salvaged and the procedures for handling jobsite debris. All Subcontractor foremen will acknowledge in writing that they have read and will abide by the CWM Plan. Subcontractor Acknowledgment Sheet enclosed. The CWM Plan will be posted at the jobsite trailer.
  5. Salvage: Excess materials that cannot be used in the project, nor returned to the vendor, will be offered to site workers, the owner, or donated to charity if feasible.
  6. [HAULING COMPANY] will provide a commingled drop box at the jobsite for most of the construction waste. These commingled drop boxes will be taken to [Sorting Facility Name and Location]. The average diversion rate for commingled waste will be ____%. As site conditions permit, additional drop boxes will be used for particular phases of construction (e.g., concrete and wood waste) to ensure the highest waste diversion rate possible.
  7. In the event that the waste diversion rate achievable via the strategy described in (6) above, is projected to be lower than what is required, then a strategy of source-separated waste diversion and/or waste stream reduction will be implemented. Source separated waste refers to jobsite waste that is not commingled but is instead allocated to a debris box designated for a single material type, such as clean wood or metal.

    Notes:

    1. Waste stream reduction refers to efforts taken by the builder to reduce the amount of waste generated by the project to below four (4) pounds per square foot of building area.
    2. When using waste stream reduction measures, the gross weight of the product is subtracted from a base weight of four (4) pounds per square foot of building area. This reduction is considered additional diversion and can be used in the waste reduction percentage calculations.
  8. [HAULING COMPANY] will track and calculate the quantity (in tons) of all waste leaving the project and calculate the waste diversion rate for the project. [HAULING COMPANY] will provide Project Manager with an updated monthly report on gross weight hauled and the waste diversion rate being achieved on the project. [HAULING COMPANY’s] monthly report will track separately the gross weights and diversion rates for commingled debris and for each source-separated waste stream leaving the project. In the event that [HAULING COMPANY] does not service any or all of the debris boxes on the project, the [HAULING COMPANY] will work with the responsible parties to track the material type and weight (in tons) in such debris boxes in order to determine waste diversion rates for these materials.
  9. In the event that Subcontractors furnish their own debris boxes as part of their scope of work, such Subcontractors shall not be excluded from complying with the CWM Plan and will provide [HAULING COMPANY] weight and waste diversion data for their debris boxes.
  10. 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.
  11. Debris from jobsite office and meeting rooms will be collected by [DISPOSAL SERVICE COMPANY]. [DISPOSAL SERVICE COMPANY] will, at a minimum, recycle office paper, plastic, metal and cardboard.

    Construction Waste Management (CWM) Worksheet

    Note: This sample form may be used to assist in documenting compliance with the waste management plan.

    Project Name: __________________________________________________
    Job Number: ___________________________________________________
    Project Manager:________________________________________________
    Waste Hauling Company: _________________________________________
    Construction Waste Management (CWM) Plan
    WASTE MATERIAL TYPEDIVERSION METHOD:PROJECTED DIVERSION RATE
    COMMINGLED AND SORTED OFF SITESOURCE SEPARATED ON SITE
    Asphalt
    Concrete
    Shotcrete
    Metals
    Wood
    Rigid insulation
    Fiberglass insulation
    Acoustic ceiling tile
    Gypsum drywall
    Carpet/carpet pad
    Plastic pipe
    Plastic buckets
    Plastic
    Hardiplank siding and boards
    Glass
    Cardboard
    Pallets
    Job office trash, paper, glass & plastic bottles, cans, plastic
    Alkaline and rechargeable batteries, toner cartridges, and electronic devices
    Other:
    Other:
    Other:
    Other:
    Construction Waste Management (CWM) Acknowledgment

    Note: This sample form may be used to assist in documenting compliance with the waste management plan.

    Project Name: __________________________________________________
    Job Number: ___________________________________________________
    Project Manager:________________________________________________
    Waste Hauling Company: _________________________________________
    CWM Plan Acknowledgment
    The Foreman for each new Subcontractor that comes on site is to receive a copy of the Construction Waste Management Plan and complete this Acknowledgment Form.
    I have read the Waste Management Plan for the project; I understand the goals of this plan and agree to follow the procedures described in this plan.
    DATESUBCONTRACTOR COMPANY NAMEFOREMAN NAMESIGNATURE

Note: Appendix D – Prescriptive Compliance Option is reprinted from the Model Water Efficient Landscape Ordinance (MWELO) contained in the California Code of Regulations, Title 23, Division 2, Chapter 2.7, Section 490, as adopted by the Department of Water Resources (DWR) on July 15, 2015. The language contained in Appendix D is reprinted herein as a resource. Please contact DWR to verify the applicable Title 23 requirements prior to using this document for enforcement purposes. For questions regarding this appendix (interpretation, effectiveness, applicability, etc.), DWR may be contacted by the following information:

California Department of Water Resources

Urban Water Use Efficiency Unit

ATTN: Julie Saare-Edmonds, Senior Environmental Scientist

P.O. Box 942836

Sacramento, CA 94236-0001 Email: Julie.Saare-

Edmonds@water.ca.gov

Telephone: 916-651-9676

http://water.ca.gov/wateruseefficiency/landscapeordinance/

Appendix D – Prescriptive Compliance Option

  1. This appendix contains prescriptive requirements which may be used as a compliance option to the Model Water Efficient Landscape Ordinance.
  2. Compliance with the following items is mandatory and must be documented on a landscape plan in order to use the prescriptive compliance option:

    1. Submit a Landscape Documentation Package which includes the following elements:

      1. date
      2. project applicant
      3. project address (if available, parcel and/or lot number(s))
      4. total landscape area (square feet), including a breakdown of turf and plant material
      5. project type (e.g., new, rehabilitated, public, private, cemetery, homeowner-installed)
      6. water supply type (e.g., potable, recycled, well) and identify the local retail water purveyor if the applicant is not served by a private well
      7. contact information for the project applicant and property owner
      8. applicant signature and date with statement, “I agree to comply with the requirements of the prescriptive compliance option to the MWELO”.
    2. Incorporate compost at a rate of at least four cubic yards per 1,000 square feet to a depth of six inches into landscape area (unless contraindicated by a soil test);
    3. Plant material shall comply with all of the following:

      1. For residential areas, install climate adapted plants that require occasional, little or no summer water (average WUCOLS plant factor 0.3) for 75% of the plant area excluding edibles and areas using recycled water; For non-residential areas, install climate adapted plants that require occasional, little or no summer water (average WUCOLS plant factor 0.3) for 100% of the plant area excluding edibles and areas using recycled water;
      2. A minimum three inch (3″) layer of mulch shall be applied on all exposed soil surfaces of planting areas except in turf areas, creeping or rooting groundcovers, or direct seeding applications where mulch is contraindicated.
    4. Turf shall comply with all of the following:

      1. Turf shall not exceed 25% of the landscape area in residential areas, and there shall be no turf in non-residential areas;
      2. Turf shall not be planted on sloped areas which exceed a slope of 1 foot vertical elevation change for every 4 feet of horizontal length;
      3. Turf is prohibited in parkways less than 10 feet wide, unless the parkway is adjacent to a parking strip and used to enter and exit vehicles. Any turf in parkways must be irrigated by subsurface irrigation or by other technology that creates no overspray or runoff.
    5. Irrigation systems shall comply with the following:

      1. Automatic irrigation controllers are required and must use evapotranspiration or soil moisture sensor data and utilize a rain sensor.
      2. Irrigation controllers shall be of a type which does not lose programming data in the event the primary power source is interrupted.
      3. Pressure regulators shall be installed on the irrigation system to ensure the dynamic pressure of the system is within the manufacturers’ recommended pressure range.
      4. Manual shut-off valves (such as a gate valve, ball valve, or butterfly valve) shall be installed as close as possible to the point of connection of the water supply.
      5. All irrigation emission devices must meet the requirements set in the ANSI standard, ASABE/ ICC 802-2014, “Landscape Irrigation Sprinkler and Emitter Standard.” All sprinkler heads installed in the landscape must document a distribution uniformity low quarter of 0.65 or higher using the protocol defined in ASABE/ICC 802-2014.
      6. Areas less than ten (10) feet in width in any direction shall be irrigated with subsurface irrigation or other means that produces no runoff or overspray.
    6. For non-residential projects with landscape areas of 1,000 sq. ft. or more, a private submeter(s) to measure landscape water use shall be installed.
  3. At the time of final inspection, the permit applicant must provide the owner of the property with a certificate of completion, certificate of installation, irrigation schedule and a schedule of landscape and irrigation maintenance.
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