HomeMy WebLinkAboutContracts & Agreements_265-2006_CCv0001.pdf State of California—Health and Human Services Agency Department of Health Services
CA DEPARTMENT OF HEALTH SERVICES
PROPOSITION 50 FUNDING PROGRAM,MS 7408
P.O.Box 997413
SACRAMENTO,CA 95899-7413 Cgs
(916)449-5600 CDHS PROPOSITION 50 FUNDING PROGRAM
Fax:(916)449-5656
APPLICATION FOR FUNDING
Water Security, Clean Drinking Water, Coastal and Beach Protection Act of 2002
Complete this funding application and mail it along with the required additional information to:
CA Department of Health Services, Proposition 50 Funding Program, MS 7408, P.O. Box 997413, Sacramento, CA 95899-7413.
For additional information(e.g. application guidelines and CEQA compliance information)visit: hftp://www.dhs.ca.gov/prol)50.
NOTE: This application will not be processed until all required information has been received by CDHS.
PUBLIC WATER SYSTEM AND/OR APPLICANT(Please print or type)
Legal Name of Applicant(Name of entity applying for funding)
City of Redlands
Public Water System Name(if applicable-See instructions) System ID Number(if CDHS Assigned ID Project#
applicable)
MUD-Water Division 3610037-6b-12/1/2004-14:51
Project Title City of Redlands Groundwater Contaminant Treatment County
and Removal with Tailored GAC San Bernardino County
Authorized representative Title
Chris Diggs Water Resources Manager
Address(number,street) City ZIP code Office Telephone
PO Box 3005 35 Cajon Street,Suite 15A Redlands, CA 92373 (909) 798-7698
e-mail Mobile Telephone Fax
cdiggs@cityofrediands.org 1( "In"' 798-7670
GRANT PROGRAM FUNDING APPLICATION (Check One)
R Chapter 4a.2-Demonstration Projects and Studies for Contaminant Treatment and Removal
E Chapter 6b-Demonstration Projects and Studies for Contaminant Removal
APPLICATION REQUIREMENTS (The following information is required to be submitted as part of this application package.)
CDHS Use Only
Contacts, Labor Compliance -Page 2 R Received R Accepted [I Complete El incomplete
Project Technical Report-Page 3 0 Received r]Accepted F1 Complete R incomplete
Environmental Documentation-Page 4 El Received R Accepted R Complete []Incomplete
Ownership,CPUC,Authority, Resolution-Page 5 0 Received [1 Accepted 0 Complete El incomplete
Financial Information-Page 6 R Received El Accepted D Complete R Incomplete
Financial and Additional Information-Page 7 R Received F1 Accepted El Complete El Incomplete
CALFED Information-Page 8 El Received ❑Accepted C1 Complete El Incomplete
APPLICATION CERTIFICATION
I declare under penalty of law that the preceding is true, and that I am authorized to sign as a responsible party
for this facility/business.
11
Signature: 00i
GO Date:
Title: 04-� §
Pat Gilbreath, Mayor Pro Tem Carrie Po)Z _' City Clerk 6-07-2007
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects(61151200 Page 1 of 8
State ufCalifornia—Health and Human Services Agency Department of Health Services
State of California—Health and Human Services Agency Department of Health Services
DOHS Assigned ID Project#
3610037-6b-I 2/l/2004-14:51
Applicant Name City of Redlands System 10 Number(if applicable)
PROJECT TECHNICAL REPORT INFORMATION (Please submit 4 paper copies or an electronic copy)
The applicant must submit a Project Technical Report that addresses the following areas of the project and the water system/applicant.
For additional information refer to the Project Technical Report Guidelines for Chapters 4a.2 and 6b Projects available at
hftp://www,dhs.ca.gov/prop5O.
Indicate by checking the appropriate boxes that the required sections of the Project Technical Included in Attached Not
Report have been addressed in the technical report,a separate document(attach a copy of the ttac I
pp,
relevant document),or is not applicable. Tech Report parately Applicable
1.Project Location, Description and Map El
2.Problem Description n
3.Description of Proposed Project
4.Project Design Elements
a. Qualifications of Applicant/Project Investigator(s) El
b. Proposed Treatment Technology F-1
c. Data Collection and Study Protocol 0
d. Ongoing Operation and Maintenance Issues
e. Public Purpose that is of Statewide Interest and Concern El
f. Peer Review Component n
g. Plan for Public Dissemination of Results and Report Submittal —EJ
h. Affordability and Operational Expertise Required to Operate the Treatment Facility
i. Handling and Disposal of Residuals
J. Operation and Maintenance Manual (Demonstration Projects Only)
k. List of Previous Studies Related to the Project
5.Evaluation of Alternatives/Cost Effectiveness
6.Anticipated Benefits of Proposed Project
El
7.Ineligible Project Components
El
8.Detailed Cost Breakdown
9.Useful Life of Key Project Components
10.Proposed Project Schedule
11.Environmental Information (refer to Env. Doc, section on pg 4 of this app.)
12.Other: Letters of In-kind Support
Comments:
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects(611512006) Page 3 of 8
State of California—Health and Human Services Agency Department of Health Services
Applicant Name City of Redlands System ID Number(if applicable) CDHS assigned ID Project#
3610037-6b-I 211/2004-14:51
PROJECT ENVIRONMENTAL DOCUMENTATION
California Environmental Quality Act(CEQA)compliance is required for all projects. For additional information refer to the
Application Guidelines. For CEQA schedules and forms visit the Prop 50 web site at: hftp://www.dhs.ca.gov/prop50.
Applicant's CEQA Representative Title Water Resources Manager
Chris Diggs
Address(number,street) City ZIP code Office Telephone
PO Box 3005 35 Cajon Street, Suite 15A Redlands, CA 92373 (909) 798-7698
e-mail Mobile Telephone Fax
cdiggs@cityofrediands.org (909) 798-7670
1.Is the applicant or any other public agency acting as the lead agency for the preparation of
environmental documents pursuant to CEQA for this project? ® Yes ❑No
2.Have any other CEQA compliance or environmental review documents for this project been drafted, adopted, or circulated?
❑ Yes. Proceed to question 3 below and indicate existing CEQA documents.
No, but applicant is or will be handling CEQA compliance. Proceed to question 4 below,
E] No,applicant is a private entity and CDHS will be the lead agency,or the applicant is unsure who should handle CEQA
compliance. Proceed to question 5 below.
1 If Yes, indicate existing CEQA document(s)and attach a copy. Attached Not Applicable
—a. Negative Declaration ❑ El
_b. Mitigated Negative Declaration El
c. EIR with State Clearinghouse Numbers on the document ❑ El
d. Notice of Determination filed w/County Clerk ❑ 1:1
e. Notice of Exemption filed w/County Clerk* ❑ E]
f. Resolution making CEQA findings ❑ El
g. Notice of Determination filed w/State Clearinghouse El El
h. Notice of Exemption filed w/State Clearinghouse El El
L Other environmental document 1:1 1:1
*If the project has been determined to be exempt, complete and attach a copy of the Prop 50 Environmental Worksheet for
CEQA Exemptions.
Prop 50 Environmental Worksheet for CEQA Exemptions Attached
4.Complete and attach a copy of the Prop 50 Schedule for CEQA Compliance.
Prop 50 Schedule for CEQA Compliance Attached
5.Complete and attach a copy of the Prop 50 Environmental Information Form. No other environmental documentation is required at
this time.
Prop 50 Environmental Information Form Attached
Provide any additional status information of the project's Environmental Documentation. Use additional sheets as necessary.
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects(6/75/200 6) Page 4 of 8
State of California-Health and Human Services Agency Department of Health Services
Applicant Name City of Redlands System ID Number(if applicable) CDHS Assigned to Project#
3610037-6b-1 2/1/2004-14:51
OWNERSHIP AND AUTHORITY OF APPLICANT (Use additional sheets as necessary)
Indicate the Ownership of the Applicant:
Public Ownership Private Ownership
!(Attach a copy of the fictitious name statement, if ❑Attached
operating under a fictitious name)
Municipality El General Corporation
❑ County Agency n Limited Corporation
❑ Special District ❑Partnership
r7l State Agency ❑Incorporated Mutual
❑ Federal Agency El Unincorporated Association
❑ Irrigation District E]Non-Profit Organization- Federal Tax ID#:
El Other: El Limited Liability Company(LLC)
El Other:
California Public Utilities Commission (CPUC) Information
1.Does the CPUC regulate the applicant's water system? El Yes El No
If Yes, attach a copy of the documentation that verifies the applicant has notified the CPUC of its intent to submit a
Prop 50 funding application. El Attached
2.Describe all matters relating to the applicant that are currently pending before the CPUC that affect or concern the financial
condition of the applicant and/or the project.
None
Funding Authority Information:
The applicant must have the legal authority to enter into a Proposition 50 funding agreement with the State of California.
1.Is the applicant required to hold an election before entering into a funding agreement? El Yes Z No
2.Provide a description of the actions that the applicant must take to obtain the necessary approvals to enter into a funding
agreement(i.e., resolution, modification of by-laws,city council approval,vote of governing body, etc.)
Vote of governing body
The necessary action will be completed by date(s):
APPLICANT RESOLUTION
The applicant must submit a resolution from the applicant's governing body designating the authorized representative and authorizing
that individual to apply for a CA Department of Health Services, Proposition 50 Funding Program grant. For an example of a resolution
visit: http://www.dhs.ca.aov/prop5O
1.Resolution Status: y governing body Approved, copy attached
2.Provide any add resolution status(i.e.,date scheduled for approval):
See Attached Resolution, dated November 21,2006
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects(611512006) Page 5 of 8
State of California—Health and Human Services Agency Department of Health Services
Applicant Name City of Redlandsem ID Number(if applicable) CDHS assigned ID Project#
T�
3610037-6b-12/1/2004-14:51
PROJECT FINANCIAL INFORMATION—ESTIMATED PROJECT COSTS (Use additional sheets as necessary)
Matching Funds
Cost Classification Total Costs Prop 50 Funds Applicant Funds Other Funds
A.Preliminary Costs $ $ 20,000 $ $
B.Design&Engineering Costs $ $ 30,000 $ $
C.Direct Labor/Personnel Costs $ $ 240,450 $ A
D.Study, Equipment,O&M, $ 872,101
Analytical, and Validation $ $ $
Costs
E. Project Management and $ $ 10,000 $ $
F.Other Costs(see below) $ 1,200,000-+ $ $ $ 1,200,000+
T $ 1,200,000+ $1,172,551 $ $ 1,200,000+
PROJECT FINANCIAL INFORMATION—SOURCES OF MATCHING FUNDS IF REQUIRED
Type of Funds Funding Status
(grants,loans In-kind (i.e.,application in progress,funding committed,cash on
Source of Funds services,user loans,
etc.) Amount hand,etc. Describe below.)
Redlands, Lockheed Martin Grants to Penn State $ 235,000 Expended 11/2003-11/2006
Siemens Water Technologies In-Kind $ 100,000 Expended 11/2003-11/2006
American WWA Research F Grant to Penn State $ 50,000 Empended 11/2003-4/2004
National Science Foundation Grant to Penn State $ 150,000 Expended 11/2003-8/2005
Redlands, Lockheed Martin In-kind Prop 50 $ 155,000 Funding Committed,for 2/2007-8/2009
Siemens Water Technologies In-kind Prop 50 _$ 50,000 Funding Committed,for 2/2007-812009
NORIT Americas Grant to Penn State $ 100,000 Expended 11/2003-12/2005
Grant to Southern $ —
American WWA Research F,etc. Nevada WA 200,000 Expended 11/2003-12/2006
Grant to Penn State,
DOD,EPA,DOE,ESTCP Siemens WT,etc. $ 1,500,000 Cash on hand 10/2005-1012007
Total Funding$ $ 2,540,000
(apply$1,200,000)
The applicant will be required to provide documentation that all required matching funds have been secured before a funding
agreement will be executed. Describe in detail the status of matching funds. In particular, describe the source of funds, application
status(if applicable),funding commitments secured, date funding will be available, conditions on funding that impact this funding
agreement, etc.
See Attached Letters and Resolutions
PROJECT FINANCIAL INFORMATION—OPERATIONS AND MAINTENANCE COSTS
Types of O&M Costs for Project Facilities Estimated Annual O&M Costs for Project :
(i.e.,labor,power,waste disposal,etc.) Facilities Sources of Funding
Labor, Power,Waste Disposal, $930,000 (for the full period of time) Prop 50 and In-kind
Operations,Analysis, and Validation
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects(611512006) Page 6 of 8
State of California—Health and Human Services Agency Department of Health Services
Applicant Name City of Redlands System ID Number(if applicable) CDHS assigned ID Project#
3610037-6
b-12/1 i2004-
APPLICANT FINANCIAL INFORMATION (Use additional sheets as necessary)
1.Attach copies of financial statements or tax returns for your entity for the past three years. Attached
2.List all cash reserves:
3.Provide a description of the planned uses of the cash reserves:
ADDITIONAL INFORMATION (Use additional sheets as necessary)
Is there any litigation pending relative to the operation of the water system(if applicable)or the
proposed project? ❑Yes ED No
If Yes, describe the pending litigation:
2.Has or will the applicant contract with a private firm or another agency for the operation,of the facility
to be funded during the study? TO Yes No
Yes
If Yes, provide the name of the firm or agency that will operate the facility and describe the terms of the agreement or contract that
includes the length of this agreement.
3.Does or will the applicant lease land or major water system facilities associated with the project? F1 Yes XNo
If Yes,describe the terms of each lease:
4-is the applicant required to prepare an Urban Water Management Plan pursuant to California Water
Code Section 10610 et seq.? Yes ❑No
If Yes,submit a copy of the plan to the DHS District office. EAttached
Does the applicant have a 20-year planning document for water demand? Yes n No
If Yes,describe the type of document(i.e., Urban Water Management Plan or other comparable public water system-planning
document),the date of preparation,the current status,etc.:
5.Is the proposed project in conformance with the planning document described in question 4? Yes r]No
If Yes,describe how the project is in conformance:
The project offers an opportunity for the City of Redlands to use wells that have already been developed,which have
perchlorate in them
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects(E1512006) Page 7 of 6
State ofCalifonnia-HealthandHomo Services Agency Department ofHealth Services
Applicant Name City of Redlands licable)CDHS assigned ID Project#
3610037-6b-I 21112004-14:51
CALFED DRINKING WATER QUALITY PROGRAM INFORMATION
NOTE: CONTACT CDHS(Prop50(&dhsca.qo )TO DETERMINE IF THIS SECTION IS APPLICABLE TO THIS PROJECT.
CDH8ioworking with the CALFED Drinking Water Quality Program to identify projects that are part of or support a multi-barrier
approach to improving drinking water quality from the Sacramento-San Joaquin Delta. The CALFEDProgram recognizes that water
quality improvement can come through many forms(from source water quality improvements to infrastructure changes to treatment
plant upgrades). The OALFEDDrinking Water Quality Program also recognizes that water quality and water supply are frequently
closely connected. For more information, please refer tmthe Application Guidelines.
Todetermine whether the proposed project supports the CALFEDobjectives, provide brief responses bothe following questions:
1.Does the water supply for this project originate in:
a.Sacramento-San Joaquin Delta? El Yes 0 No
b.Delta Watershed(including watersheds of upstream reservoirs)? El Yes Z No
c.California Aqueduct or similar conveyances? El Yes 0 No
d.Other areas of the state t hat supply water to systems connected to the Delta? El Yes Z No
If"Yes"was answered to any water supply listed above, attach a brief description(1-2 paragraphs each,or more as needed), and
proceed tothe following questions.
If'No"was answered to all water supply listed above, skip questions 2 through 5. Nofurther CALFEDDrinking Water Quality Program
information is required.
2.Does the project improve drinking water quality regarding: Yes(attach description,see Item 3 below) No
a.Organic Carbon El
b.Bromide El 0
c.Microbial Pathogens El El
d.Salinity El 11
e.Nutrients El El
f.Turbidity El El
g.Taste El
h.Disinfection Byproducts(THMs, bromate, HAA5) Z
i.Odor El El
3.Attach a brief description(I to 2 paragraphs)of the estimated relative magnitude,frequency, and location(i.e., portion of service
area)ofthe expected change ofthese constituents aaaresult oYthis project. Attached
4.Does this project assist in meeting existing or anticipated regulations,and if so which ones? |fnot,does itaddress aninternal
water U |andif so, briefly describe.
Assists in meeting perchlorate standards in California, and addresses water quality goals and standards pertaining to
radioactivity,endocrine disruptors,chlorinated organics, BTX,chromium, pesticides, and nitrate
Attach abrief response hathese questions. (If this information is provided elsewhere in the application or the technical report,
please state where the information can befound) Not appflcable DAttaohed
5.If you believe that this project would result in improved water quality for users of the Sacramento-San Joaquin Delta water supply
and have not been able to describe it through the above questions,attach a brief description.
The thermally tailored activated carbons that wewill betesting|nthis groundwater demonstration will also remove
odorants such as MIB and geosmin better than do conventional activated carbons.
DHS Prop 5VFunding Application for Chapters 4a2and 8bProjects U61151200 U Page OofD
AGENDA ITEM NO.
COUNCIL MEETING OF 11/21/06
REQUEST FOR COUNCIL ACTION
SUBJECT. ADOPTION OF RESOLUTION 6556 AUTHORIZING SUBMISSION OF
AN APPLICATION FOR A PROPOSITION 50 RESEARCH GRANT
MOTION:
I move that the City Council adopt Resolution 6556 to authorize submission of an application for
a Proposition 50 Research Grant.
STAFF RECOMMENDATION:
Staff recommends that the City Council adopt Resolution No. 6556 to authorize submission of an
application for a Proposition 50 Research Grant.
DISCUSSION:
In November, 2002 California voters passed Proposition 50, the Water Security, Clean Drinking
Water, Coastal and Beach Protection Act of 2002. Proposition 50 provides up to $3.44 billion in
funding in eight different categorical program areas in California, including funds for technical
research associated with development of new contaminant removal technologies. In September,
2004 the California Department of Health Services (DHS) issued a notice inviting water agencies
to submit pre-applications for funding through the various programs the agency administers
under Proposition 50.
Since 2003, the City has been working collaboratively with Pennsylvania State University and
Siemens Water Technologies to develop treatment technology for cost-effective removal of
ammonium perchlorate and other contaminants from groundwater. These efforts are focused on
treatment facilities at the City's Texas St. Wellfield, due to the availability of infrastructure,
including treatment vessels for various resin compounds. Since beginning the research project,
the City and Penn State have increased the scope of testing from small bench scale efforts to a
full demonstration scale program. The research performed to date has provided significant data
regarding treatment methods for perchlorate removal, and appears to have long-term potential for
use in groundwater treatment. If the treatment is approved for water production use, the City
would directly benefit by reclaiming its Texas St. wells for potable water production. These
wells were taken out of service in 1997 due to perchlorate contamination, except for a brief
period in 2002 when operations were conducted under an emergency permit from the State.
Funding for the project has been provided at various times by an American Water Works
Association Grant, Lockheed Martin Corp., Siemens Water Technologies, and the City of
Redlands.
Based on the success of the research efforts to date, the Municipal Utilities Department met with
staff from the Department of Health Services and Penn State to determine whether the project
ADOPTION OF RESOLUTION 6556 AUTHORIZING SUBMISSION OF AN APPLICATION
FOR PROPOSITION 50 RESEARCH GRANT
City Council Meeting of November 21, 2006
Page 3
Prepared by: Concurrence:
GREG GE G Y G. LPS
Capital Projects Manager Municip tilities Director
Recommend Reviewed By:
SAM J. RACADIU DANIEL J. MIPHUGH
Interim City Manager City Attorney
for the Mentone Boulevard Sewer Pipeline Installation Project, Project
No. 2-0725, to Nikola Construction Company based on the total bid amount of
$582,146.00, authorized the Mayor to execute, and the City Clerk to attest to,
the document on behalf of the City, and authorized staff to approve contingent
costs up to ten percent (10%) over the initial bid amount.
Awreements - Mentone Boulevard Sewer Pipeline Proiect - On motion of
Councilmember Gilbreath, seconded by Councilmember Gallagher, the City
Council unanimously approved an agreement to furnish professional surveying
services with O'Bryant Surveying in the amount of $2,780.00 and authorized
the Mayor to execute, and the City Clerk to attest to, the document on behalf of
the City. On motion of Councilmember Gilbreath, seconded by Councilmember
Gallagher, the City Council unanimously approved an agreement to furnish
construction inspection and testing services with Hilltop Geotechnical, Inc. for
the Mentone Boulevard Sewer Pipeline Project in the amount of$13,472.00 and
authorized the Mayor to execute, and the City Clerk to attest to, the document
on behalf of the City.
Resolution No. .6556 - Proposition 50 Research. Grant - On motion of
Councilmember Gilbreath, seconded by Councilmember Gallagher, the City
Council unanimously adopted Resolution No. 6556, a resolution of the City
Council of the City of Redlands authorizing the submission of an application for
grant funding pursuant to Chapter 4a2 and/or Chapter 6b of the Water Security,
Clean Drinking Water, Coastal and Beach Protection Act of 2002, Water Code
Section 79560 et seq., (Proposition 50), to continue working collaboratively
with Pennsylvania State University and Siemens Water Technologies to develop
treatment technology for cost-efTective removal of ammonium perchlorate and
other contaminants from the groundwater.
Aareernent - Hinckley Water Treatment Plant - On motion of Councilmember
Gilbreath, seconded by Councilmember Gallagher, the City Council
unanimously approved an agreement to perform professional engineering
services for an initial system evaluation and preliminary design report with
Carollo Engineers for the Hinckley Water Treatment Plant and authorized the
Mayor to execute, and the City Clerk to attest to, the document on behalf of the
City.
Funds - Senior Transportation - On motion of Councilmember Gilbreath,
seconded by Councilmember Gallagher, the City Council unanimously approved
an agreement with the County of San Bernardino, Department of Aging and
Adult Services, to assist in funding of the senior transportation program in the
amount of$5,200.00 and authorized the Mayor to execute, and the City Clerk to
attest to, the document on behalf of the City.
November-"1,2006
Page 3
RESOLUTION 6556
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF REDLANDS
AUTHORIZING THE SUBMISSION OF AN APPLICATION FOR GRANT
FUNDING PURSUANT TO CHAPTER 4a2 AND/OR CHAPTER 6b OF THE WATER
SECURITY, CLEAN DRINKING WATER, COASTAL AND BEACH PROTECTION
ACT OF 2002, WATER CODE SECTION 79560 et seq., (PROPOSITION 50).
WHEREAS, the City of Redlands has the authority to construct, operate, and maintain the City
of Redlands Water System; and
WHEREAS, the City of Redlands desires to enhance the provision and protection of the drinking
water supplied to the consumers of the City of Redlands Water System;
NOW, THERERORE, BE IT RESOLVED by the City Council of the City of Redlands that,
pursuant and subject to all of the terms and provisions of the Water Security, Clean Drinking Water,
Coastal and Beach Protection Act of 2002 (Proposition 50) and all amendments thereto, application be
made to the State of California for funding; and
BE IT FURTHER RESOLVED that Mr. Jon Harrison, Mayor of said City of Redlands is hereby
authorized and directed to cause the necessary data to be prepared, investigations to be performed and
application to be signed and filed with the State of California.
ADOPTED, SIGNED AND APPROVED at a regular meeting of the City Council of the City of
Redlands on this 21st day of November, 2006.
Jo "arrison, Mayor
ATTEST:
C'—Wza
Lzec yzer, C166kk
1, Lorrie Poyzer, City Clerk of the City of Redlands, hereby certify that the foregoing resolution was
duly adopted by the City Council at a regular meeting thereof held on the 21 st day of November, 2006,
by the following vote:
AYES: Councilmembers Gilbreath, Gil, Gallagher, Aguilar; Mayor Harrison
NOES: None
ABSENT: None
ABSTAIN: None
Loff /Poyzer, i�4rk
716
State of California—Health and Human Services Agency Department of Health Services
CA DEPARTMENT OF HEALTH SERVICES
PROPOSITION 50 FUNDING PROGRAM, MS 7408
P.O. Box 997413 CfKS
SACRAMENTO,CA 95899-7413 CDHS PROPOSITION 50 FUNDING PROGRAM
(916)449-5600
Fax:(916)449-5656
APPLICATION FOR FUNDING
Water Security, Clean Drinking Water, Coastal and Beach Protection Act of 2042
Complete this funding application and mail it along with the required additional information to:
CA Department of Health Services, Proposition 50 Funding Program,MS 7408, P.O. Box 997413, Sacramento, CA 95899-7413.
For additional information(e.g. application guidelines and CEQA compliance information)visit: http://www,dhs.ca.gov/prop6O.
NOTE: This application will not be processed until all required information has been received by CDHS.
PUBLIC WATER SYSTEM ANCHOR APPLICANT(Please,print or type)
Legal Name of Applicant(Name of entity applying for funding)
City of Redlands
Public Water System Name(if applicable-See instructions) System ID Number(if CDHS Assigned ID Project#
applicable)
MUD-Water Division 36'10037-6b-121112004-14:51
Project Title City of Redlands Groundwater Contaminant Treatment County
and Removal with Tailored GAC San Bernardino County
Authorized representative Title
Greg Gage Capital Projects Manager
Address(number,street) City ZIP code Office Telephone
PO Box 3005 35 Cajon Street, Suite 15A Redlands, CA 92373 (909)798-7698
e-mail Mobile Telephone Fax
ggage@cityofrediands.org { } (909)798-7670
GRANT PROGRAM FUNDINGAPPLICATION (Check One)
❑Chapter 4a.2—Demonstration Projects and Studies for Contaminant Treatment and Removal
®Chapter 6b—Demonstration Projects and Studies for Contaminant Removal
APPLICATION REQUIREMENTS(The following information is required to be submitted as part of this application package.)
CDHS Use Only
Contacts, Labor Compliance —Page 2 Q Deceived ❑Accepted ' El Complete Q incomplete
Project Technical Report—Page 3 El Received Q Accepted ❑Complete C}incomplete
Environmental Documentation—Page 4 Q Received ❑Accepted 0 Complete El incomplete
Ownership, CPUC,Authority, Resolution—Page 5 ❑Received (Accepted 0Complete El Incomplete
Financial Information—Page 6 0 Received ❑Accepted ❑Complete Incomplete
Financial and Additional Information—Page 7 C3 Received ❑Accepted ❑Complete ❑Incomplete
CALFED Information—Page 8 0 Received Q Accepted 0 Complete d incomplete
APPLICATION CERTIFICATION
I declare under penalty of law that the preceding is true,and that I am authorized to sign as a responsible party
for this facilitAbusinesjs.
Signature: Date;
Attest:
Title:
j 12/22/06
cin Harrison, Mayor Lortle PoyZ citTClerk
DHS Prop 50 Funding Application for Chapters 4a2 and 6b Projects 6t{ 151200.66) Page 1 of 8