Cal. Code Regs. Tit. 23, div. 2, ch. 2.7, app C

Current through Register 2024 Notice Reg. No. 43, October 25, 2024

Appendix C - Sample Certificate of Completion

CERTIFICATE OF COMPLETION

This certificate is filled out by the project applicant upon completion of the landscape project.

PART 1. PROJECT INFORMATION SHEET

Date
Project Name
Name of Project Applicant	Telephone No.
	Fax No.
Title	Email Address
Company	Street Address
City	State	Zip Code

Project Address and Location:

Street Address	Parcel, tract or lot number, if available.
City	Latitude/Longitude (optional)
State	Zip Code

Property Owner or his/her designee:

Name	Telephone No.
	Fax No.
Title	Email Address
Company	Street Address
City	State	Zip Code

Property Owner

"I/we certify that I/we have received copies of all the documents within the Landscape Documentation Package and the Certificate of Completion and that it is our responsibility to see that the project is maintained in accordance with the Landscape and Irrigation Maintenance Schedule."

___________________________
Property Owner Signature	Date

Please answer the questions below:

1. Date the Landscape Documentation Package was submitted to the local agency__________

2. Date the Landscape Documentation Package was approved by the local agency__________

3. Date that a copy of the Water Efficient Landscape Worksheet (including the Water Budget Calculation) was submitted to the local water purveyor__________

PART 2. CERTIFICATION OF INSTALLATION ACCORDING TO THE LANDSCAPE DOCUMENTATION PACKAGE

"I/we certify that based upon periodic site observations, the work has been completed in accordance with the ordinance and that the landscape planting and irrigation installation conform with the criteria and specifications of the approved Landscape Documentation Package."

Signature*	Date
Name (print)	Telephone No.
	Fax No.
Title	Email Address
License No. or Certification No.
Company	Street Address
City	State	Zip Code
* Signer of the landscape design plan, signer of the irrigation plan, or a licensed landscape contractor.

PART 3. IRRIGATION SCHEDULING

Attach parameters for setting the irrigation schedule on controller per ordinance Section 492.10.

PART 4. SCHEDULE OF LANDSCAPE AND IRRIGATION MAINTENANCE

Attach schedule of Landscape and Irrigation Maintenance per ordinance Section 492.11.

PART 5. LANDSCAPE IRRIGATION AUDIT REPORT

Attach Landscape Irrigation Audit Report per ordinance Section 492.12.

PART 6. SOIL MANAGEMENT REPORT

Attach soil analysis report, if not previously submitted with the Landscape Documentation Package per ordinance Section 492.6.

Attach documentation verifying implementation of recommendations from soil analysis report per ordinance Section 492.6.

Cal. Code Regs. Tit. 23, div. 2, ch. 2.7, app C

1. New Appendix C filed 9-10-2009; operative 9-10-2009 pursuant to Government Code section 11343.4 (Register 2009, No. 37).
2. Repealer and new Appendix C filed 9-15-2015; operative 9-15-2015. Exempt from OAL review and submitted to OAL for printing only pursuant to Governor's Executive Order No. B-29-15 (4-1-2015) (Register 2015, No. 38).

1. New Appendix C filed 9-10-2009; operative 9-10-2009 pursuant to Government Code section 11343.4 (Register 2009, No. 37).
2. Repealer and new Appendix C filed 9-15-2015; operative 9/15/2015. Exempt from OAL review and submitted to OAL for printing only pursuant to Governor's Executive Order No. B-29-15 (4-1-2015) (Register 2015, No. 38).