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Name of Applicant: North Table Mountain Water & Sanitation District Date Received: February 15, 2011 HB 05 -1254: (Implementation) Evaluation for Entities j. Yes No Comments: Is the applicant a covered entity? x Does the covered entity have a state approved water conservation plan in x June 23, 2009 accordance with statutory revision 37 -60 -126? (HB 04- 1365)? (If answered no to the above question) then, Does the covered entity have x a locally adopted water conservation plan with defined water saving goals? Did the applicant provide a written statement from the entity's governing x board, stating the entity's commitment to the project and the entity's commitment to implementing long -term water saving measures and programs (w /authorized signature)? Did the applicant provide a cover letter with the entity's: name, contact x information, and a signature of an individual with the authority to commit the resources of the entity? Did the applicant provide a list of people and/or organizations that will be x involved in assisting with the grant project (list of who will be utilizing the grant money)? Characterizing Water System: Did the entity provide their annual retail water demand for the past five x Pg. 3, 4 years (in acre ft. or million gallons)? Did the entity identify their retail water delivery for each of the past five x Page 3, 4 years (in acre feet or million gallons)? (Not required, but preferred), Did the applicant provide information x Page 4 characterizing past water use by sector, (e.g. residential, commercial, and industrial) and the source (e.g. surface water, groundwater, etc). Did the entity provide current (and if available past) per capita water use x Page 5 for the last five years and the basis for this calculation? Did the entity provide their past, current, and predicted future population x Table 3, pg. 5 served by the entity, (and the source of this information)? Table 4, pg. 6 Did the entity state the water savings that was accomplished in the past x Pg. 7, 8 and Tbl 5 five years through water conservation efforts? Did the entity state water savings goals to be achieved through the x Pg. 9; 3c implementation of the "project "? Adequacy, Stability, and reliability of the entity's water system x Pg. 8 *to be measured and examined by staff through analysis Description of Project: Did the applicant write a paragraph stating the purpose and the primary x Pg. 2 features of the project? Pg. 10 Did the applicant provide a detailed narrative (description) of tasks to be x Sonic Leak performed with grant monies (stating how grant money will be used to Landscape Regs. achieve project goals)? *(a "scope of work" can combine this item with Irrigation Audits the timeline described below)