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Name of Applicant: Svc+�Riry ww«r er_ oi r c.. - <br /> Date Received: Io/3 / l2 13 <br /> Grant Amount: Ica)coo-1 Sri)81--5' <br /> HB 05-1254: Evaluation Checklist for Entities <br /> For Cove ed Entity Applicant: Yes No Comments: <br /> Is the applicant a covered entity? <br /> Does the covered entity have a state approved water conservation plan in P12-1 '2-c711 <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 /> 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 /> 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 /> involved in assisting with the grant project(list of who will be utilizing <br /> the grant money)? <br /> Characterizing Water System: <br /> Did the entity provide their annual retail water demand (Metered Water <br /> ?A-sr "0r 11-1C-1-4,Ce <br /> Use) for the past five years (in acre ft. or million gallons)? V y . (#.1 r;ra - <br /> Did the entity identify their retail water delivery (Distributed Water) for <br /> each of the past five years (in acre feet or million gallons)? <br /> (Not required, but preferred), Did the applicant provide information s,,r,, , <br /> characterizing past water use by sector, (e.g. residential, commercial, and v' <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 ✓ tcow9 °4 '^' 'f <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 /> served by the entity, (and the source of this information)? <br /> Did the entity state the water savings that was accomplished in the past <br /> five years through water conservation efforts? <br /> Did the entity state water savings goals to be achieved through the o wsaT <br /> implementation of the"project"? t.e.s Ij+-boep-sT74-4)0F. Lesqa <br /> Adequacy, Stability, and reliability of the entity's water system ✓- <br /> *to be measured and examined by staff through analysis <br /> Description of Project: <br /> Did the applicant write a paragraph stating the purpose and the primary <br /> features of the project? <br /> Did the applicant provide a detailed narrative (description) of tasks to be <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 />