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Name of Applicant: PjA q uL <br />Date Received: 1 - <br />- �i f —v► se d. --v,5u6mi k. Z1 1-1 Of( <br />HB 04- 1365: Evaluation checklist for OWCDP staff <br />i <br />Applicant Demonstrates: <br />Yes <br />No <br />Comments: <br />That it is I covered entity <br />,pswIiVd: no' *-fo the above question, then is it an entity which will <br />soon become a covered entity? <br />(Only answer this question if the applicant is NOT currently a <br />"covered" entity) Did they provide a reasonable engineering estimate <br />of future annual retail demand for the next 3 -5 yrs. , all based on <br />population projections, building permits, expected new taps, and or <br />some other creditable information that would show that the entity will <br />become a "covered" entity <br />Disclosure of organizational structure /chart <br />X <br />not,, 10- <br />Current retail water demand for each of the past five years (in acre ft. <br />or million gallons) <br />A written statement from the entity's governing board, stating the <br />entity's commitment to the "plan' ' and the implementation of long -term <br />water savings measures and programs (w /authorized signature) <br />Cover letter with the entities: name, contact information , and a <br />signature of an individual with the authority to commit the resources of <br />X <br />the entity <br />A list of people and/or organizations that will be involved in assisting <br />with putting the plan together (list of who will be utilizing the grant <br />money) <br />Not required, but preferred, Information characterizing past water use <br />by sector, (e.g. residential commercial, industrial) and the source (e.g. <br />surface wet ,groundwater, etc <br />IFV <br />Characterize ion of the water system: <br />SJ� C� Y <br />`Curren (and if available past) per capita water use for the last five <br />yVays, anti the basis, for. this calculation <br />Past, current,t an - pred fed, future popdlatio}i served by the entity, (and <br />3 Oat - <br />the 'our f ° �:tiais information) ' ' <br />Q�'} <br />i��t„3 t.; src i ~` <br />List � §tr'm (,,water savings to be achieved through the <br />impl&fiontati bft y e `'Plan ", based Qrnwater system, t pas <br />�P <br />co sgrva�tion effort and. he� f6uir'e water needs _ <br />Adequacy, Stabiliti, and reliability o the entity's water system. <br />*to <br />k <br />be measurhlla id examined by staff through analysis <br />P, stating the purpose and the primary features of the entity's. <br />1 <br />- ire'to,create <br />a water conservation plan <br />G1, detailed narrative (description) of tasks to be performed with grant <br />m6bies (related to the water conservation plan, and "water efficiency <br />G <br />measures) *(a "scope of work" can combine this item with the timeline <br />t <br />described below) <br />Statement of a financial need <br />S <br />l <br />