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Name of Applicant: St. Charles Mesa Water District <br />Date Received: April 28, 2011 <br />HB 05 -1254: (ImDlementation) Evaluation for Entities <br />Fir CMere+d 1CMtiy' <br />Yes <br />No <br />Comments: <br />Is the applicant a covered entity? <br />X <br />Pg. 1— 2000AF /Y <br />Does the covered entity have a state approved water conservation plan in <br />X <br />12/2010 <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 />a locally adopted water conservation plan with defined water saving <br />goals? <br />Did the applicant provide a written statement from the entity's governing <br />X <br />board, stating the entity's commitment to the project and the entity's <br />commitment to implementing long -term water saving measures and <br />programs (w /authorized signature)? <br />Did the applicant provide a cover letter with the entity's: name, contact <br />X <br />information, and a signature of an individual with the authority to commit <br />the resources of the entity? <br />Did the applicant provide a list of people and /or organizations that will be <br />X <br />involved in assisting with the grant project (list of who will be utilizing <br />the grant money)? <br />Characterizing Water System: <br />- - - -- <br />-- - -- <br />- -- ----- ---- <br />Did the entity provide their annual retail water demand for the past five <br />X <br />Tbl. 3 -1 bottom <br />years (in acre ft. or million gallons)? Use <br />Did the entity identify their retail water delivery for each of the past five <br />X <br />Tbl. 3 -1 top <br />years (in acre feet or million gallons)? <br />(Not required, but preferred), Did the applicant provide information <br />characterizing past water use by sector, (e.g. residential, commercial, and <br />industrial) 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 />Tbl. 3 -2 <br />for 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 />Tbl. 3 -3; <br />served by the entity, (and the source of this information)? <br />residential growth <br />rate <br />Did the entity state the water savings that was accomplished in the asst <br />X <br />2010 —will send <br />five years through water conservation efforts? <br />Did the entity state water savings goals to be achieved through the <br />X <br />Tbl. 3-4,3-5 <br />implementation of the "project "? <br />Adequacy, 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 />features of the project? <br />Did the applicant provide a detailed narrative (description) of tasks to be <br />X <br />performed 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 />the timeline described below) <br />