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Name of Applicant: Left Hand Water District Date Received: 1/18/2011 HB 05 -1254: (Implementation) Evaluation for Entities Yes No Comments: Is the applicant a covered entity? x Does the covered entity have a state approved water conservation plan in x 2008 accordance with statutory revision 37 -60 -126? (HB 04- 1365)? (If answered no to the above question) then, Does the covered entity have - - - a locally adopted water conservation plan with defined water saving goals? Did the applicant provide a written statement from the entity's governing 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 Christopher information, and a signature of an individual with the authority to commit Smith, LHWD the resources of the entity? Engineer Mgr. & Kathy Peterson, Dist. Mgr. Did the applicant provide a list of people and/or organizations that will be x Pg. 1 /2 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 years (in acre ft. or million gallons)? Did the entity identify their retail water delivery for each of the past five x Pg. 2 years (in acre feet or million gallons)? (Not required, but preferred), Did the applicant provide information x Pg. 3 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 Pg. 3 for the last five years and the basis for this calculation? Did the entity provide their past, current, and predicted future population x Pg. 4, What is the served by the entity, (and the source of this information)? date of Census used? Did the entity state the water savings that was accomplished in the past x Pg. 5/6 five years through water conservation efforts? Did the entity state water savings goals to be achieved through the x Pg. 4/5 implementation of the "project "? Adequacy, Stability, and reliability of the entity's water system x Pg. 7 *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 features of the project? Did the applicant provide a detailed narrative (description) of tasks to be x See Appendices performed with grant monies (stating how grant money will be used to A, B & C achieve project goals)? *(a "scope of work" can combine this item with the timeline described below)