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Name of Applicant: _Town of Firestone <br />Date Received: May 10, 2010, <br />HIS U�I-UZW Evaluation cnecxust for r.nnues <br />Yes <br />No <br />Comments: <br />B the applicant a covered entity? <br />x <br />Does the covered entity have a state approved water conservation plan in <br />x <br />accordance with statutory revision 37 -60 -126? (HB 04- 1365)? <br />;If answered no to the above question) then, Does the covered entity have <br />t locally adopted water conservation plan with defined water saving <br />Ovals? <br />Did the applicant provide disclosure of its organizational structure/chart? <br />x <br />Did the applicant provide its charter? <br />x <br />Did the applicant provide a written statement from the entity's governing <br />x <br />Statement in <br />)oard, stating the entity's commitment to the project and the entity's <br />cover letter <br />;ommitment to implementing long -term water saving measures and <br />programs (w /authorized signature)? <br />Did the applicant provide a cover letter with the entity name, contact <br />x <br />nformation, and a signature of an individual with the authority to commit <br />he resources of the entity? <br />Did the applicant provide a list of people and/or organizations that will be <br />x <br />Pg.1 and 2 <br />nvolved in assisting with the grant project (list of who will be utilizing <br />he grant money)? <br />characterizin Water System: <br />- - - -- <br />- - - -- <br />---- ----- - -- <br />Did the entity provide their annual retail water demand for the past five <br />x <br />years (in acre ft. or million gallons)? <br />Did the entity identify their retail water delivery for each of the past five <br />x <br />Tears (in acre feet or million gallons)? <br />Not required, but preferred), Did the applicant provide information <br />x <br />;haracterizing past water use by sector, (e.g. residential, commercial, and <br />ndustrial) and the source (e.g. surface water, groundwater, etc). <br />Did the entity provide current (and if available past) per capita water use <br />x <br />'or the last five years and the basis for this calculation? <br />Did the entity provide their past, current, and predicted future population <br />x <br />;erved by the entity, (and the source of this information)? <br />Did the entity state the water savings that was accomplished in the asst <br />x <br />We years through water conservation efforts? <br />Did the entity state water savings goals to be achieved through the <br />x <br />mplementation of the "project "? <br />kdequacy, Stability, and reliability of the entity's water system <br />x <br />`to be measured and examined by staff through analysis <br />Description of Proiect: <br />- - - - -- <br />- - - -- <br />------- -- - - -- <br />Did the applicant write a paragraph stating the purpose and the primary <br />x <br />'eatures of the project? <br />Did the applicant provide a detailed narrative (description) of tasks to be <br />x <br />)erformed with grant monies (stating how grant money will be used to <br />achieve project goals)? *(a "scope of work" can combine this item with <br />he timeline described below) <br />