Atwater City Council
November 12, 2024

Technology Solutions You Can Trust | Shasta Union High School District Initials: _______
At the core, Ray Morgan’s Document Fulfillment Services is data processing. We offer substantial EDI capabilities, which automates the processing of input data and controls the flow of the data internally as it is processed. This system allows us to accept a variety data formats (PCL, ASCII Text, Flat Text, PDF, PS, TIFF Image, XML, HTML and Metacode) as input.

Once the data is processed, the output can be delivered in any formatted required by the customer, whether it be a standard PDF for print production, raw data (XML) or specialized formatting for returning formatted files to a customer’s document management system and/or client facing portals. RMC is flexible to your requirements and current system capabilities.

Piece Level Tracking & Visibility:

Every job submitted for processing is assigned a work order number. This work order contains the pre-defined specifications of that job which is automatically created when injected into our system. This automation creates consistency and reliability across all jobs processed to maintain the accuracy required in mailing sensitive information on behalf of our customers.

Security & Compliance: Data and your client information is secure! We support HTTPS, SFTP and email as electronic data transmission protocols. Generally, the input data from our customers is received via SFTP. Our FTP server sits behind our firewall and the FTP server software supports SSH-2 (Secure FTP) connections which encrypt communication for the data transfer to and from DFS. The FTP Server is enabled with use authentication as well as flood and DoS (Denial of Service) Attack Protection. To further ensure file security DFS supports PGP file encryption of any files transmitted between DFS and our customers. DFS has gone to great lengths to ensure data transmitted to DFS is secure. Once data is received, it is encrypted at rest and is only decrypted for processing and printing. SOC 2 TYPE II Certified Complete Visibility from client portal
The online customer portal is available 24/7 and allows for full automated processing through our system, no matter when the files are uploaded. When a file is received via the customer portal a work order is automatically generated, this work order number travels with the job throughout the entire data processing, printing & mailing process.

Redundancy & Back Up
Production facility (40,000 Sq. Feet) in Sacramento, Ca. is a physically secure and monitored via camera (inside and out) with only key fob entry. All employees are bonded. As a normal part of operations, we continually update services and technology as appropriate. State-of-the-art back-up generator system set up that will eliminate any production down time in the event of a power failure.

Related Tech: RMC’s Managed Print Plus Services
Ray Morgan Company can elevate client’s imaging fleet support by providing on-site device lifecycle management.
 Strategy and design -Service Area Analysis: We capture your needs and translate them into innovative solutions using industry leading technology and measured service levels  Transition and Implementation Process: We design and manage the transition and implementation

Technology Solutions You Can Trust | Shasta Union High School District Initials: _______
 Operations and Best Practices: We leverage best practices that closely monitor the technology and services provided
 Employee focus: We consistently develop and motivate employees to deliver high level service  Customer Collaboration: Consistent service area reviews to monitor and collaborate on your Operations strategy to maintain alignment with your objectives The Service Delivery Manager (SDM, On Site/Fleet manager) is the primary contact for services for departments supported by the Managed Print Plus Program. The SDM manages the delivery of RMC Services, which includes managing document output devices (printers, copiers, and fax machines) at contracted locations with a focus on:
 Maximizing uptime
 Utilization
 Optimization
 User satisfaction
 Minimizing costs
After ensuring achievement of Service Level Agreements, the SDM is responsible for working with the client to improve business processes through optimization and use of the print devices. The SDM must possess an indepth understanding of the client’s requirements and domain, be IT centric, enabling communication with the Customer IT Department resources. Understands networks and utilize managed document services technology:

Communicates account Business Process opportunities to the supporting sales and professional service teams.

Assists other support team members in developing, implementing and managing ongoing fleet operations.

1. RMC will work the hours of 8:00 a.m. to 5:00 p.m., Monday through Friday.

2. Run daily proactive activities in the morning when arriving to work a. Confirm online
b. Check for toner alerts
c. Check for service alerts
d. Check for user requests

3. Check device monitoring que to prioritize the morning activities

4. Start proactive activities and monitor the que threw out the day

5. First level support on MFD and printer equipment to place back in service if possible or to place and manage service calls.

6. Assist with end user spot training per request.

7. Provide Monthly and Quarterly reports
a. Meters
b. Ticket activity

8. Participate in Monthly and Quarterly Reviews
SECTION IV: INVOICING
Contract Administration & Invoicing Capabilities

Technology Solutions You Can Trust | Shasta Union High School District Initials: _______
All billing and account administration for SUHSD will be handled locally in our Chico office. The result is that the SUHSD will always have a quick response from our friendly staff that will be familiar with the account in order to ensure the best possible customer service experience.

Invoices can be sent via hard copy or electronically based on the SUHSD’s billing requirements. Specific machine identifiers (machine IDs) are assigned to each machine. The invoice will include the machine id, serial number, machine model and location. To assist in the SUHSD’s internal billing process, a unique department code or accounting code can also be
added to the invoice by machine or groups of machine. Based on the type of contract implemented, electronic spreadsheet billing may also be available.

It is RMC’s recommendation that there be a standing quarterly meeting between RMC and SUHSD to review device
performance, level of service performance, accuracy of
invoicing and any upcoming changes or additions that may occur. While this is not mandatory, it has proven helpful in other installations
Custom spreadsheet billing with .CSV formatting

CLOSING STATEMENT
Multi-Page Hardcopy - Invoice Billing

Technology Solutions You Can Trust | Shasta Union High School District Initials: _______
In closing, we would like to thank the Shasta Unified High School District evaluation staff for the opportunity to propose our solutions and compete for your business. We feel that your decision to offer the utilization of this resulting contract to other government entities throughout California is a positive for the entire state.

Technology Solutions You Can Trust | Shasta Union High School District Initials: _______

6. NET PROMOTER SCORE

Technology Solutions You Can Trust | Shasta Union High School District Initials: _______

7. CUSTOM BILLING SAMPLE

CITY COUNCIL

AGENDA REPORT

MEETING
DATE:

November 12, 2024
TO: Mayor and City Council
FROM: Justin Vinson, Public Works Director

PREPARED
BY:

Greg Thompson, Deputy City Manager/Community Development Director
SUBJECT: Authorizing A Financial Assistance Application with the State Water Resources Control Board for the Evergreen Mobile Home Project (Deputy City Manager/Community Development Director Thompson)

RECOMMENDED COUNCIL ACTION
Adoption of Resolution No. 3505-24 authorizing the City Manager or his designee to execute all agreements/documents related to the Evergreen Mobile Home Financial Assistance Application.

I. BACKGROUND/ANALYSIS:

Evergreen Mobile Home Park is located at 6357 Shaffer Road in Winton, California. It is a mobile home park with approximately 7 residential units. The mobile home park currently has its own water system that has one well that serves the residential units on site. The well currently has detections above the maximum contaminant level (MCL) of 1,2,3-Trichloropropane (TCP). Since this is a mobile home park, it is considered a community water system, and falls under the regulations of the State Water Resources Control Board.

Self-Help Enterprises is a nationally recognized community development organization whose mission is to work together with low-income families to build and sustain healthy homes and communities. The State Water Resources Control Board reached out to Self-Help to assist with determining whether the mobile home park could install treatment for TCP. Self-Help also evaluated whether the mobile home park could afford to maintain the cost of treatment for TCP. It was determined that the cost of treating the water for the mobile home park to safe drinking water standards was going to be too burdensome for the mobile home park, so the State Water Resources Control Board and Self-Help reached out to surrounding water systems, including the City of Atwater, Winton Water and Sanitary District, and others. After analysis, it was determined that the City of Atwater's water system was the closest water system to the mobile home park, and would be the lowest construction cost to deliver safe and clean drinking water.

CITY COUNCIL
Mike Nelson, Mayor
Danny Ambriz Tyler Button
John Cale Brian Raymond

Agenda Report - Authorizing A Financial Assistance Application with the State Water Resources Control Board for the Evergreen Mobile Home Project (Deputy City Manager/Community Development Director Thompson) Page 2

The State Water Resources Control Board and Self-Help reached out to the City staff to see if Atwater would be willing to serve water to the mobile home community. The state would fully fund the project, from environmental, to design, permitting, and construction.

Staff were open to this idea, even though the mobile home park is not currently in the city limits or the sphere of influence. There are two reasons for this. First, the staff is aligned with the state that everyone should receive clean and safe drinking water, and second, the project would build a 12" water main along Shaffer Road, north of Sante Fe.

This water main would extend past parcels that are projected to be included in the new sphere of influence for the city, and it will promote future development on these parcels, since the cost of development will not have to include constructing a water main under a railroad crossing and also extending the water main from the city limits to the new sphere of influence.

Even though this project will be taking place in the County of Merced, the City of Atwater will be the lead agency. This is because of grant funding, the mobile home park is not eligible for the grant funding and the extension of the water main is considered growth inducing in terms of CEQA. The state has already hired a consultant to perform the environmental analysis for this project as well as the design for this project. The County of Merced will have to be involved, since work will be taking place in their right of way, and the mobile home park is located currently in their jurisdiction. This project is anticipated to take around 12–15 months before it is completed.

II. FISCAL IMPACTS:

There are no expected fiscal impacts for the grant application. The State Water Resources Control Board is expected to fully fund the application and the project.

This item has been reviewed by the Finance Department.

III. LEGAL REVIEW:

This item has been reviewed by the City Attorney's Office.

IV. EXISTING POLICY:

This project is consistent with goal number one (1) of the City's 2020-2025 Strategic Plan: to ensure the City's continued financial stability.

V. ALTERNATIVES:

N/A
VI. INTERDEPARTMENTAL COORDINATION:

This report will be routed to all necessary departments.

VII. PUBLIC PARTICIPATION:

The public will have an opportunity to provide comments on this item prior to City

Agenda Report - Authorizing A Financial Assistance Application with the State Water Resources Control Board for the Evergreen Mobile Home Project (Deputy City Manager/Community Development Director Thompson) Page 3

Council action.

VIII. ENVIRONMENTAL REVIEW:

This project is currently under an environmental review. Staff will come back with the findings once the review is completed.

IX. STEPS FOLLOWING APPROVAL:

Authorize the City Manager to execute and the City Clerk certifying the authorizing resolution.

Submitted by:

Greg Thompson, Deputy City Manager/Community Development Director Submitted by:

Justin Vinson, Public Works Director
Approved by:

Chris Hoem, City Manager
Attachments:

1. RSO Authorizing a Financial Assistance Application with the State Water Resources Control Board for the Evergreen Mobile Home Project

2. dwsrf-application-general

3. h3-dwsrf-application-const-technical

4. h4_dwsrf_application_const_environmental

5. h5-dwsrf-application-const-financial

CITY COUNCIL
OF THE

CITY OF ATWATER
RESOLUTION NO. XXXX-24

A RESOLUTION OF THE CITY COUNCIL OF THE

CITY OF ATWATER AUTHORIZING AND

DIRECTING THE CITY MANAGER TO EXECUTE

FINANCIAL ASSISTANCE APPLICATION OR

DOCUMENTS REQUIRED FOR EVERGREEN

MOBILE HOME PROJECT
WHEREAS, the City of Atwater is eligible to receive State funding for certain projects; and
WHEREAS, the City of Atwater was approved to receive state funding for the Evergreen Mobile Home Project; and
WHEREAS, the City of Atwater will be considered the lead agency for this project; and WHEREAS, the City of Atwater is not anticipated to have any cost for the completion of the Evergreen Mobile Home Project; and
WHEREAS, an authorizing resolution identifying the official authorized to execute agreements or documents on behalf of the City must be attached to the Agreement.

NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Atwater that the City Manager, or his designee, is hereby authorized and directed to sign and file, for and on behalf of the Entity, a Financial Assistance Application for a financing agreement from the State Water Resources Control Board for the planning, design, and construction of the Evergreen Mobile Home Project
The Authorized Representative, or his designee, is designated to provide the assurances, certifications, and commitments required for the financial assistance application, including executing a financial assistance agreement from the State Water Resources Control Board and any amendments or changes thereto.

The Authorized Representative, or his designee, is designated to represent the Entity in carrying out the Entity’s responsibilities under the financing agreement, including certifying disbursement requests on behalf of the Entity and compliance with applicable state and federal laws.

Resolution No. XXXX-24 Page 2
The foregoing resolution is hereby adopted this 12th day of Novemeber 2024.

AYES:

NOES:

ABSENT:

APPROVED:

________________________________

MIKE NELSON, MAYOR
ATTEST:
_______________________________
KORY J. BILLINGS, CITY CLERK

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund

STATE WATER RESOURCES CONTROL BOARD
Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120

GENERAL INFORMATION PACKAGE
The General Application and attachments may be submitted in one of three ways. Applicants are encouraged to utilize the Financial Assistance Application Submittal Tool (FAAST) to streamline the application submittal and review process, but if that will create a hardship, email or mail can be utilized instead:

1.) Apply online via the FAAST: https://faast.waterboards.ca.gov To submit a DWSRF Application in FAAST, you must complete all the tabs in FAAST and attach (at minimum) the General Information Package. (Note: Once the DWSRF Application has been uploaded, you must still complete the application by clicking on the “Submit” button.) Once the DWSRF Application is submitted in FAAST, a project manager will be assigned to help the applicant complete the application process.

To submit additional documents for the same project, do not start a new application. Instead, click on the Submitted Applications link on the Main Menu and choose the project from the list of previously submitted applications. Open the Attachments tab, and then the Post-Submission sub-tab. Choose a document from the Attachment Category dropdown list and then select the file to upload. The project manager will receive an email notification letting them know you have submitted additional information for review.

If you need assistance, you can also contact the FAAST Help Desk, which is staffed Monday through Friday 8am through 5pm, at 1-866-434-1083 or [email protected].

2.) To submit a DWSRF Application via email, please use the following email address:

[email protected]

3.) To submit a DWSRF Application via mail, please use the following address:

State Water Resources Control Board
Division of Financial Assistance
P.O. Box 944212
Sacramento, CA 94244-2120

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
General Application Instructions
Check the box to indicate the type of project (planning or construction) needing financial assistance.

Section I - Applicant Information
Applicant Name – Enter the entity that will be the legal signatory to a financing agreement.

Street Address, City, State, Zip – Enter the applicant’s physical street address. The Zip+4 Code can be found at https://tools.usps.com/go/ZipLookupAction.

Mailing Address, City, State, Zip – Enter the applicant’s mailing address, if different from the street address.

Applicant Total Population – Enter the total applicant service area population.

Applicant Total Number of Service Connections – Provide the total number of active service connections that are currently and directly served by the water system. This includes all residential, industrial, commercial, and other connections.

Current year median household income (MHI) – Enter the current year median household income of the applicant or project service area. An official MHI Determination will be conducted during the review of this General Application Package.

Congressional District(s) – Enter the Congressional district(s) where the project will be physically located.

If the project will span multiple Congressional Districts (i.e., a pipeline project), list all affected districts. A map of California Congressional Districts can be found at https://www.house.gov/representatives/find-yourrepresentative.

State Senate District(s) & State Assembly District(s) – Enter the State Senate district(s) and State Assembly district(s) where the project will be physically located. Refer to http://findyourrep.legislature.ca.gov/.

Unique Entity Identifier (UEI) No. – This number is required to receive a financial assistance agreement. If the applicant does not have a UEI number, more information is available at https://sam.gov/content/entityregistration.

Federal Tax ID No. – Enter the Federal tax identification number of the applicant.

Authorized Representative Name, Title – Identify the person who has the authority to represent the applicant and sign documents pertaining to the funding application. If the applicant is a public agency or has a governing board, the application must include a copy of a resolution adopted by the governing body designating its authorized representative and authorizing the submission of an application. If the applicant does not have a governing board, then it must provide documentation supporting the authorization of the authorized representative. It is advisable to designate the title of the position authorized to sign and submit an application rather than naming a specific person. The funding application must be signed by the authorized representative.

Auth. Rep. Phone & Email - Enter the authorized representative’s telephone number and email address.

Contact Person Name – Enter the name of the person who is the day-to-day contact for the project. This

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
person should be able to answer general questions about the project and application.

Contact Person Phone & Email – Enter the contact person’s telephone number and email.

Local Counsel Name – Enter the name of the applicant’s general counsel. Borrowers with existing bond debt will also need to provide contact information for bond counsel.

Local Counsel Phone & Email – Enter the local counsel’s telephone number and email.

Section II - Project Information and Proposed Schedules Project Title – Enter the title or name of the project. This name should match that on the CEQA documents, resolution, and any other existing documents.

Project Description and Objectives – Provide a brief description of the project and its objectives.

Current Status of Plans and Specifications – Provide the current status in percent complete.

Amount of Financial Assistance Requested – Provide the amount of financial assistance requested.

Total Project Cost (If More Than the Amount of Assistance Requested) – Provide the total project cost.

Water Supply Permit Number – Enter permit number and attach a copy of the water supply permit, along with any enforcement orders (label as Attachment G1).

Population Served by Project – Enter the population served by the Project.

Estimated Project Schedule – Provide an estimated or actual date for the following:
• Adopt Environmental Documents
• 100% Plans & Specifications
• Start of Construction/Implementation
• Complete Construction/Implementation
Consultation with Other Agencies – Provide the following:
• Name of other federal or state agencies involved in this project (e.g. planning, CEQA/NEPA consultation, funding, etc.)
• Contact information for the named agencies
• Brief descriptions of the status of these consultations Partnering Agencies – Provide the name and contact information of all other agencies that have an interest in the project, their contact information if known, and brief description of their roles.

Other Funding Sources – Provide a list of other funding sources for this project. Include the amount and an estimate date on which the funding will be available.

Section III – Managerial Information
Classification of Water System – Check the box that represents your type of system. If you are unsure of the classification of your system, refer to the system’s domestic water supply permit or refer to the Decision Tree for Classification of Water Systems flow chart located at https://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/docs/class_dec_tree.pdf.

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Ownership and Organization of the Water System – Check the box(es) that corresponds to the ownership of your water system.

Municipalities – If the Applicant is a Municipality, indicate if the Applicant is a Charter City.

Privately-owned entities - Non-community water systems are only eligible for DWSRF funding if they qualify as a non-profit entity. Non-profit owners of non-community water systems must include the appropriate IRS non-profit ID number and Tax-Exempt Status form IRS 501(c).

Privately owned systems must include a copy of the fictitious name statement, if they are operated under a name that is different than their owner’s legal name, and must provide a copy of their owner’s organizational documents, and federal tax returns or other financial document (label as Attachment G2).

The following is a list of organizational and financial documents for different types of for-profit or non-profit private water systems:

Limited Liability Company
• Applicable federal tax return for the last 3 years (e.g., Form 1040 (sole proprietor), Form 1065 (partnership), or Form 1120 (corporation))
• Articles of Organization, with all amendments, certified by Secretary of State (CA) • Executed Operating Agreement
• Fictitious Business Name (FBN) Statement (if using any name other than the exact name that is on record with the Secretary of State’s Office)
• Secretary of State Entity/File Number
Partnership
• Partnership Agreement(s)
• Statement of Partnership Authority (Form GP-1), filed with Secretary of State • Federal tax return for the last 3 years (e.g., Form 1065) • Majority owner’s last three years of personal tax returns • Fictitious Business Name (FBN) Statement (if using a name that does not include the surname of each general partner or a name that suggests the existence of additional owners such as “Company,” “& Company,” “& Son,” “& Sons,” “& Associates,” “Brothers,” and the like) For-Profit Corporation
• Articles of Incorporation, with all amendments, certified by Secretary of State (CA) • Bylaws
• Fictitious Business Name (FBN) Statement (if using any name other than the exact name that is on record with the Secretary of State’s Office)
• Federal tax return for the last 3 years (e.g., Form 1120 (C-Corp) or Form 1120S (S-Corp)) Non-Profit Corporation
• Articles of Incorporation, with all amendments, certified by Secretary of State (CA) • Bylaws
• IRS Tax Exempt Determination IRS 501(c)
• Latest Annual Report filed with the California Registry of Charitable Trusts • Filed Fictitious Business Name Certificate (DBA) (if applicable) • Federal tax return of organization exempt from income tax Form 990 – most recent 3 years Sole Proprietorship
• Filed Fictitious Business Name (FBN) Statement (if using any name that does not include the last

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
name (surname) of the owner, or which implies additional owners) • Federal tax return Form 1040, including schedules – most recent 3 years Trusts
• Trust or Certification of Trust, signed by all currently acting trustees – discuss with DFA prior to submitting
• For revocable trust, federal tax return of grantor Form 1040, including schedules – most recent 3 years
• For irrevocable trust, Form 1041 – most recent 3 years Corporations, LLCs, and Partnerships – If your water system is a Corporation (e.g. mutual water company; incorporated homeowners association), Limited Liability Company, or Partnership, list your water system’s California Secretary of State Entity Number as well as your water system’s filing status with the California Secretary of State. Information relating to a Corporation’s, Limited Liability Company’s, or Partnership’s filings with the Secretary of State can be found at the following website:
https://sos.ca.gov/business- programs/business-entities/.

Does the California Public Utility Commission (CPUC) regulate your system? – Indicate whether your water system is regulated by the CPUC. Include (1) the CPUC resolution that authorized acquisition/construction/extension of your system; (2) the most recent annual report filed with the CPUC; (3) the most recent general rate case documents; (4) CPUC audit reports, if any; and (5) a list of all actions or matters associated with your system that are currently pending before the CPUC, as well as all filings associated with those actions or matters. Water systems regulated by the CPUC must submit any required CPUC approval or notification to enter into a funding agreement for DWSRF financing. (label as Attachment G3) Names, titles and duties of key officers or decision-making personnel – Provide the name, title, and duties of key officers or decision-making personnel of the water system. Submit an organization chart showing the names, titles, and the reporting relationship of all key persons involved with the operation of the water system.

The organization chart does not need to describe all personnel employed by the system, only those persons that have primary responsibilities for making decisions that affect the operation of the water system. Submit an organizational chart showing parent, subsidiary, or otherwise affiliated entity structures, or submit a certification that there are none (label as Attachment G4).

Is there any pending litigation, sale of system property, or audit/investigation? – Indicate if there is any litigation, sale of system property, or audit/investigation pending with respect to the water system’s assets or water rights or relative to the operation of the water system or the proposed project. Litigation or audits/investigations involving operators, officers, and decision-making personnel should be included. If yes, submit a description of the matter and potential costs or liabilities, (label as Attachment G5).

Is the applicant leasing land or major water system facilities? – Indicate if the applicant is leasing land or any major water system facilities. If yes, describe the terms of the lease and submit a copy of the lease agreement (label as Attachment G6). If the lease is critical to the location or operation of the proposed project facilities, the term of the lease is expected to extend through the useful life of the project and cannot be shorter than the loan repayment period of the DWSRF financing.

Include a general map of the service area/boundaries – The map must include service boundaries, and existing source(s), storage, treatment, and distribution system. (label as Attachment G7) Does the applicant have a contract with a private firm or another agency? – Indicate if the applicant has a

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
contract with a private firm or another agency for the operation of the facility to be financed. If yes, indicate the name of the firm or agency and term (in years) of the agreement and submit a copy of the agreement (label as Attachment G8).

Prior to the State Water Board’s approval of the project, specific water conservation and urban water management requirements must be achieved.

1. Urban Water Suppliers – Urban Water Suppliers (defined as a water supplier, either publicly or privately owned, that directly or indirectly provides potable municipal water to more than 3,000 customers or that supplies more than 3,000 acre-feet of potable water annually at retail for municipal purposes) must submit proof of Urban Water Management Plan (UWMP) submittals to the Department of Water Resources (label as Attachment G9):

2. Certification for Compliance with Water Metering Form – Water Code section 529.5 requires urban water purveyors to meet metering requirements. If you are an urban water supplier (i.e., supply to more than 3,000 customers or supplying more than 3,000 acre-feet annually), you must comply with this requirement. Please consult with your legal counsel and review section 529.5 of the Water Code before completing this certification (Attachment G10).

Potential Flags – To avoid potential delays later in the application process, it is required that the applicant complete and submit this worksheet to alert the Division staff of any issues that may potentially affect the application review. (Attachment G11)
Authorized Representative Resolution/Ordinance – (for use by publicly owned entities): Submit this attachment here only if not submitting the Financial Security Package. This resolution or ordinance designates the Authorized Representative(s) for the project, who will have the authority to sign and submit the DWSRF application materials, certify compliance with applicable state and federal laws, execute the financial assistance agreement and amendments, and certify disbursement requests.  To minimize the potential for problems, use of the exact language in the template resolution is recommended.
 Enter the title of the Authorized Representative, NOT a person’s name.  Do not modify the words financing or financial assistance to other terms such as “loan”, “grant”, or “principal forgiveness”. Use of these terms may create legal complications; the terms “financing” and “financial assistance” are broad enough to be applicable to all of the above. (Attachment G12) Corporate Resolution to Apply, Borrow and Grant Security (for use by private applicants) – This resolution designates the Authorized Representative(s) for the project, who will have the authority to sign and submit the DWSRF application materials, certify compliance with applicable state and federal laws, execute the financial assistance agreement and amendments, certify disbursement requests, grant security interest, and authorize State Water Resources Control Board to perform any acts necessary to perfect security. • To minimize the potential for problems, use of the exact language in the template resolution is recommended.
• Enter the title of the Authorized Representative, NOT a person’s name. (Attachment G13) Other Entity Type – If you are a limited partnership, general partnership, trust, or sole proprietor identify your authority for designating an Authorized Representative and include relevant governance documents that provide for that authority. If you are a trust, include the Trust or Certification of Trust. (Attachment G14)

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Payee Data Record, STD 204 (for use by private applicants) – Complete and submit this attachment located at: https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf. (Attachment G15) Government Agency Taxpayer ID Form (for use by public applicants) – Complete and submit this attachment located at: https://business.ca.gov/wp-content/uploads/2021/09/Government-Agency-Taxpayer-IDForm-1.pdf. (Attachment G16) Section IV – Attachments
G1 – Water Supply Permit and Enforcement Orders
G2 – Ownership Documentation, for private entities
G3 – CPUC Documentation (if applicable)
G4 – Organization Chart (if applicable)
G5 – Pending Litigation, Sale, or Audit/Investigation (if applicable) G6 – Lease Agreement (if applicable)
G7 – Service Area Map
G8 – Operating Agreement (if applicable)
G9 – Urban Water Supplier Conservation Document (if applicable) G10 – Certification for Compliance with Water Metering Form G11 – Potential DWSRF Flags Worksheet
G12 – Authorized Representative Resolution/Ordinance (publicly owned entities) G13 – Corporate Resolution (for private entities)
G14 – Other Entity Type
G15 – Payee Data Record, STD 204 (for private entities) G16 – Government Agency Taxpayer ID Form (publicly owned entities) Certification and Signature of Authorized Representative ✓ Print the name and title of the authorized representative. ✓ Sign and date the application.

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
General Application Package
☐ PLANNING ☐ CONSTRUCTION
I. APPLICANT INFORMATION
Applicant Name:

Street Address:

Mailing Address:

City:

City:

State:

State:

Zip+4 Code:

Zip+4 Code:

Applicant Total Population:

Applicant Total Number of Service Connections: Residential: Commercial:

Industrial: Other:

Current year median household income (MHI):

Congressional District(s):

State Senate District(s):

State Assembly District(s):

Data Universal Numbering System (DUNS) No.: Federal Tax ID No.:

Authorized Representative Name: Title:

Phone No.: Email Address:

Contact Person Name:

Phone No.: Email Address:

Local Counsel Name:

Phone No.: Email Address:

II. PROJECT INFORMATION AND PROPOSED SCHEDULE
Project Title:

Project Description and Objectives:

Current Status of Plans & Specifications, Percent (%):

Estimated Amount of Financial Assistance Requested:

Total Project Cost (If More Than the Amount of Assistance Requested):

Water Supply Permit Number (Attachment G1):

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Population Served by Project:

Currently Estimated
Project Schedule: Adopt Environmental Documents:
100% Plans & Specifications:

Start of Construction/Implementation:

Complete Construction/Implementation:

Estimated or Actual Date
Consultation with Other Agencies
Please list other federal and state agencies that have been involved in this project (e.g. planning, CEQA/NEPA consultation, funding, etc.), their contact information if known, and estimated dates for resolution of any issues.

Partnering Agencies
Please list all other agencies that have an interest in this project, their contact information if known, and brief descriptions of their roles.

Other Funding Sources
List any other funding sources for this project, along with the amount of additional funding and date of availability III. MANAGERIAL INFORMATION
Classification of Water System:
☐Community ☐Non-transient non-community ☐Transient non-community ☐Not currently classified as a public water system

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Indicate the Ownership of the Water System (check all that apply):
 Include the ownership documentation (See instructions for further information) (label as Attachment G2)
Public Ownership
☐Municipality ☐County Agency ☐Special District ☐State Agency ☐Public School ☐Other:

Private Ownership
☐Corporation ☐Limited Liability Company ☐Partnership ☐Sole Proprietorship ☐ Non-profit Organization ☐Other:
 If the water system is privately-owned, indicate the name and title of the individual with authority to engage the water system in a DWSRF financing agreement. Click or tap here to enter text.  If the Water System is a Municipality, is the Water System a Charter City? ☐Yes ☐No  If the Water System is a Corporation, Limited Liability Company, or Partnership, complete the following:

A. California Secretary of State Entity Number:

B. Status with California Secretary of State:
☐Active ☐Suspended ☐Forfeited ☐Dissolved
Is the Water System regulated by the California Public Utilities Commission (CPUC)? ☐Yes ☐No If yes, the Water System must obtain CPUC approval. Attach the documentation identified in the Application instructions (label as Attachment G3).

List the names, titles and duties of key officers and attach an organization chart providing this information.

List the names and affiliation of all parent, subsidiary, or otherwise affiliated entities and attach a chart providing this information. If none, indicate that here. ☐ N/A (label as Attachment G4) Is there any litigation, sale, or audit/investigation pending relative to the operation of the water system or the proposed project or key personnel or officers?
☐Yes ☐No
If yes, attach a description of the litigation and the potential costs (label as Attachment G5).

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Is the Water System leasing land or major water system facilities? ☐Yes ☐No If yes, describe the terms of the lease or attach a copy of the lease agreement (label as Attachment G6). (NOTE:

If the lease is critical to the location or operation of the proposed project facilities, the term of the lease should be as long as the useful life of the proposed project facilities and cannot be shorter than the loan repayment period.) Include a general map of the service area/boundaries (label as Attachment G7):
[For Construction Projects Only] Does the Water System have a contract with a private firm or another agency for the operation of the facility to be financed? ☐Yes ☐No If yes, provide the name of the firm or agency and term (in years) of the agreement and attach a copy of the agreement (label as Attachment G8)
Water Conservation

1. Are you an urban water supplier as defined in Water Code Section 10617? ☐YES ☐NO
If yes, submit a copy of your Urban Water Management Plan per Water Code Section 10653 (Label as Attachment G9).

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Signature of Authorized Representative: Date:

Name of Authorized Representative: Title:

To the best of my knowledge and belief, I certify that I am authorized to submit this application; the information provided in this application is true and correct; the documentation has been duly authorized by the governing body of the applicant; and the entity possesses the legal authority to apply for the financing and enter into a financing agreement with the State Water Resources Control Board and to finance and construct the proposed facilities.

CERTIFICATION AND SIGNATURE OF AUTHORIZED REPRESENTATIVE

2. Attach Certification for Compliance with Water Metering Form (label as Attachment G10).

IV. ATTACHMENTS
☐ G1 – Water Supply Permit and Enforcement Orders
☐ G2 – Ownership Documentation
☐ G3 – CPUC Documentation (if applicable)
☐ G4 – Organization Chart(s) (if applicable)
☐ G5 – Pending Litigation, Sale, or Audit/Investigation (if applicable) ☐ G6 – Lease Agreement (if applicable)
☐ G7 – Service Area Map
☐ G8 – Operating Agreement
☐ G9 – Urban Water Supplier Conservation Document (if applicable) ☐ G10 – Certification for Compliance with Water Metering Form ☐ G11 – Potential DWSRF Flags Worksheet
☐ G12 – Authorized Representative Resolution/Ordinance (publicly owned entities) ☐ G13 – Corporate Resolution (for private entities)
☐ G14 – Other Entity Type

Attachment G10
Name of Authorized Representative: Title:

Signature of Authorized Representative: Date:

CERTIFICATION FOR COMPLIANCE WITH WATER METERING

REQUIREMENTS FOR FUNDING APPLICATIONS
Funding Agency Name: State Water Resources Control Board Funding Program Name: Drinking Water State Revolving Fund Applicant (Agency Name):

Please check one of the boxes below and sign and date this form. ☐ As the authorized representative for the applicant agency, I certify under penalty of perjury that the agency is not an urban water supplier, as that term is understood pursuant to the provisions of section 529.5 of the Water Code, and that the applicant agency is in compliance with Water Code, section 525, requiring a suitable water meter to be installed as a condition of new water service. ☐ As the authorized representative for the applicant agency, I certify under penalty of perjury that the applicant agency has fully complied with the provisions of Division 1, Chapter 8, Article 3.5 of the California Water Code (sections 525 through 529.7 inclusive), as applicable and that the ordinances, rules, or regulations submitted with this certification as listed below have been duly adopted and are in effect as of this date.

I understand that the Funding Agency will rely on this signed certification in order to approve funding and that false and/or inaccurate representations in this Certification Statement may result in loss of all funds awarded to the applicant for its project. Additionally, for the aforementioned reasons, the Funding Agency may withhold disbursement of project funds, and/or pursue any other applicable legal remedy.

Drinking Water State Revolving Fund
Drinking Water State Revolving Fund (DWSRF) Program
Potential DWSRF Flags Worksheet
Attachment G11
Financial Assistance
Application (Rev. 05/2024)
To avoid potential delays later in your DWSRF application process, we recommend you review the following list of questions and statements, and place a check (✓) beside each question or statement where your answer is “yes” or “true”.

If you answer “yes” or “true” to any of the questions or statements on this worksheet, we recommend that you discuss the specifics of your answers with the State Water Board, Division of Financial Assistance staff at your earliest opportunity so we can identify issues up front that may require supplementary information or additional review time. Although it is not a required application attachment, we recommend you submit this worksheet with your “General Information Package”.

Applicant (Entity) Name
Project Title:

Contact Person: Phone:
✓ if
Yes
or
True
LEGAL
Question / Statement

1.a. If you anticipate grant-only funding, after reviewing and discussing with your attorney(s), do you have any concerns regarding your ability to comply with the Exhibit C Standard Terms and Conditions used for all DFA funding agreements? Terms and conditions:
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/general_terms.html

1. b. If you anticipate repayable financing from the Board (i.e., a loan), after reviewing and discussing the form of agreement and forms of opinion of counsel, do you have any concerns regarding your ability to comply with the Board’s standard terms and conditions or provide opinion(s) of counsel?

2. Is there doubt about whether your governing statutes allow you to finance your project through the DWSRF?

3. Is there existing or pending litigation with respect to your system’s assets, water rights, or regarding the source of repayment or implementation of the project?

4. Are there any existing or pending inquiries or investigations of your agency, members of the board of directors, or key management by outside entities, for example, the Grand Jury?

5. Was there a significant level of protests during the most recent rate setting process?

6. Is there an existing or pending rate rollback initiative on an upcoming ballot, or are there any efforts within the community to initiate a rate rollback? Have rates been rolled back in the past due to a voter initiative?

7. Has there been or is there currently significant disagreement within the community about the project?

8. Will the project involve a public-private partnership?

Drinking Water State Revolving Fund
Drinking Water State Revolving Fund (DWSRF) Program
Potential DWSRF Flags Worksheet
Attachment G11
Financial Assistance
Application (Rev. 05/2024)

9. Are you a small community or a dependent special district anticipating that some or all of your financial assistance will be a repayable loan?

10. Are you a State agency, a Native American Tribe, a federal entity, or a non-governmental entity?

11. Are you a Joint Powers Authority or are there agreements with other entities related to the project?

12. Do you need to purchase or otherwise obtain legal access rights to the project property for the term of the financing to implement the project?

13. Are you not the owner of all of the system’s property?

14. Are there liens on any of the system’s property?

15. Do your property rights for any of the property needed for the Project extend for less than 33 years from the date of the application or are subject to revocation?

16. Does the application include the purchase of land or other assets?

17. Do you expect to use eminent domain so that you can implement your project?

18. If you are a private entity, are you not in good standing with the California Secretary of State and the Franchise Tax Board?

19. If you are a private entity, are you domiciled and registered outside of California?

Drinking Water State Revolving Fund
Drinking Water State Revolving Fund (DWSRF) Program
Potential DWSRF Flags Worksheet
Attachment G11
Financial Assistance
Application (Rev. 05/2024)
✓ if
Yes
or
True

TECHNICAL
Question / Statement

1. Do you anticipate that the plans & specifications will be out for bids within the next 6 to 12 months (i.e., likely before receiving an executed financing agreement)?

2. The project bidding is complete, but the specifications did not include the Build America, Buy America (BABA), the American Iron and Steel, Disadvantaged Business Enterprises, or Davis-Bacon requirements.

3. You are an urban water supplier and your project is a water management project as defined by Water Code section 10631 (AB 1420). You have not received a compliance letter from the Department of Water Resources.

4. Is this a regionalization project, or will the project be a joint effort with other agencies?

5. The plans and specifications have not been reviewed and/or approved by the Division of Drinking Water for permitting purposes.

6. Do you have policies and procedures to solicit, evaluate, and select candidates for professional services using a fair, competitive selection process based on demonstrated competence and professional qualifications, consistent with California Government Code section 4526.

7. Do you anticipate the project will be implemented in phases with multiple bids?

8. Do you anticipate the project will be implemented with a Design-Build delivery method? ✓ if
Yes
or
True

ENVIRONMENTAL
Question / Statement

1. The environmental documents have not been prepared for the proposed project.

2. The environmental documents were not prepared to meet “federal cross-cutting” requirements.

3. Will the project impact any cultural resources?

4. Will the project impact any state or federally listed species?

5. Will the project require consultations with the United States Fish and Wildlife Service or the National Marine Fisheries Service?

6. Will the project’s air quality emissions (construction and operation) exceed the federal de minimis levels, and require a general conformity determination?

7. Will the project require a Clean Water Act Section 404 permit and a Section 401 Certification?

Drinking Water State Revolving Fund
Drinking Water State Revolving Fund (DWSRF) Program
Potential DWSRF Flags Worksheet
Attachment G11
Financial Assistance
Application (Rev. 05/2024)

8. Is there any significant controversy related to the project’s environmental documents?

9. Were the project’s environmental documents approved more than five years from the expected date of the DWSRF financing agreement?

10. If the water system is private and there is no local discretion, has the water system discussed with the local agency about carrying out the CEQA lead agency role?

11. Is it anticipated that the Lead Agency for the potential construction project will be an agency other than the Applicant?

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Drinking Water State Revolving Fund (DWSRF) Program
Potential DWSRF Flags Worksheet
Attachment G11
✓ if
Yes
or
True

FINANCIAL
Question / Statement

1. Is the entity’s status “Suspended” with the Secretary of State?

2. If non-profit, is the entity unable to provide a copy of its tax exemption confirmation statement from the IRS? If not non-profit, please enter “N/A” in the box.

3. Are you missing any portion of the necessary Project funding aside from what is being sought as part of this application? Please enter “N/A” in the box if no additional funding sources are necessary.

4. Has the entity ever failed to make timely and sufficient payments on its existing loans within the past 10 years? If none, please enter “N/A” in the box.

5. Are you planning to pledge a repayment source other than Net Revenues of your water enterprise, as defined in Appendix E to the DWSRF Policy?

6. Are your annual revenues currently insufficient to cover annual expenses?

7. Will you be requesting approval of your DWSRF financing before rates, assessments, or other charges used to support repayment are adopted?

8. Do you have outstanding fines or penalties due to non-compliance with a permit or order?

9. Do you have existing debt that relies on the same source of revenue as the source you plan to pledge for repayment of the DWSRF financing?

10. Will the Project be co-funded with funding other than the Drinking Water State Revolving Fund?

11. Was the last rate study completed over five years ago?

12. Do your existing debt covenants affect your ability to incur new parity debt, and/or are non-compliant with existing debt covenants?

13. Are you currently out of compliance or have you been out of compliance with covenants in your existing debt in the preceding 5 years?

14. Have you had a prior material event such as a bankruptcy, default, unscheduled draw on reserve funds, substitution of insurers on their failure to perform, or unscheduled draw on a credit enhancement in the preceding 10 years?

15. Are you subject to a lien on any portion of the system property?

16. If you are a government entity, do you have a local debt limit?

17. Have you taken actions in anticipation of the sale of significant system assets?

18. Have you taken actions in anticipation of restructuring or dissolution?

19. Have you taken actions in anticipation of filing for bankruptcy protection or other insolvency proceedings?

Financial Assistance Application
(Rev. 05/2024)

Drinking Water State Revolving Fund
Drinking Water State Revolving Fund (DWSRF) Program
Potential DWSRF Flags Worksheet
Attachment G11
Name of Authorized Representative: Title:

Signature of Authorized Representative: Date:

Attachment G12

AUTHORIZED REPRESENTATIVE RESOLUTION/ORDINANCE
RESOLUTION NO: _____________________
WHEREAS _____________________________________________________________________________ (insert appropriate findings)
RESOLVED BY THE _______________________________________________________________OF THE (insert name of Governing Board of the Entity)
_______________________________________________________________ (the “Entity”), AS FOLLOWS:
(insert Entity name)
The ____________________________________________ (the “Authorized Representative”) or designee is (insert Title of Authorized Representative)
hereby authorized and directed to sign and file, for and on behalf of the Entity, a Financial Assistance Application for a financing agreement from the State Water Resources Control Board for the planning, design, and construction of ___________________________________________________________ (the “Project”). (insert Project Name)
This Authorized Representative, or his/her designee, is designated to provide the assurances, certifications, and commitments required for the financial assistance application, including executing a financial assistance agreement from the State Water Resources Control Board and any amendments or changes thereto.

The Authorized Representative, or his/her designee, is designated to represent the Entity in carrying out the Entity’s responsibilities under the financing agreement, including certifying disbursement requests on behalf of the Entity and compliance with applicable state and federal laws.

Ayes [Boards Members voting yes]
Nos [Board Members voting no]

CERTIFICATION
I do hereby certify that the foregoing is a full, true, and correct copy of a resolution duly and regularly adopted at a meeting of the ___________________________________________________________ held
(insert name of Governing Board of the Entity)
on ______________________.
(Date)
(Name, Signature, and Seal of the Clerk or Authorized Record Keeper of the Governing Board of the Agency)

Drinking Water State Revolving Fund
Attachment G13
Financial Assistance Application
(Rev. 05/2024)
[This is a sample template of a corporate resolution designating authority to apply, borrow, and grant security for financing, as applicable. The specific language will vary based on the type of the applicant and on the requirements of the corporation’s articles of incorporation, bylaws and other corporate documents, and should be prepared in consultation with the corporation’s attorney. Note that prior to the State Water Resources Control Board executing a financial assistance agreement, it may be required that the applicant’s board of directors adopt a resolution authorizing the agreement as issued.] _____________[Date]
RESOLUTION No.___

RESOLUTION OF THE BOARD OF DIRECTORS OF
__________________________________________________________________ [Applicant entity’s legal name ]

DESIGNATING AUTHORITY TO

TO APPLY, BORROW AND TO GRANT SECURITY
WHEREAS,_________________________________________________, is a California [for-profit/ non-profit] [Applicant entity’s legal name]
corporation in good standing with the California Secretary of State (the “Company”); WHEREAS, the Company owns and operates a community water system known as _________________ ____________________________________with [ ] connections; WHEREAS, the Company [is/ is not] a water corporation subject to regulation by the California Public Utilities Commission;
WHEREAS, the Company [is/ is not] a mutual water company as defined in Section 14300 of the Corp. Code; WHEREAS, the Company seeks financing from the State Water Resources Control Board (“State Water Board”) for a project commonly known as _________________________________________________________ (“Project”);
WHEREAS, the Project has a clear and definite public purpose, and will benefits customers of the water system and not the investors;
WHEREAS, the Board of Directors adopted a Project budget; and WHEREAS, prior to the State Water Board issuing a financing agreement, the Board of Directors is required to establish a dedicated source of revenue to repay the DWSRF loan and authorizing an officer to execute all corresponding agreements, amendments, and certifications.

1. NOW, THEREFORE BE IT RESOLVED, that the ________________________________is hereby (insert title of Authorized Representative)
authorized and directed to sign and file, for and on behalf of the Company, an application for financial assistance from the State Water Board for the planning, design, and/or construction of the Project;

2. BE IT FURTHER RESOLVED, that the Authorized Representative is designated to provide the assurances, certifications, and commitments required for the financial assistance application, including executing a financial assistance agreement from the State Water Board and any amendments or changes thereto;

3. BE IT FURTHER RESOLVED, that the Authorized Representative is hereby authorized to incur Indebtedness not to exceed $_____________________ pursuant to the DWSRF financing

Drinking Water State Revolving Fund
Attachment G13
Financial Assistance Application
(Rev. 05/2024)
agreement (The term "Indebtedness" as used herein means all debts, obligations and liabilities, currently existing or now or hereafter made, incurred or created in connection with the financing);

4. BE IT FURTHER RESOLVED, that the Authorized Representative is hereby authorized to grant security interests in, pledge, assign, transfer, endorse, mortgage or otherwise hypothecate to the State Water Board, and execute security or pledge agreements, financial statements and other security interest perfection documentation, mortgages and deeds of trust on, and give trust receipts for, any or all property or assets of the Company as may be agreed upon by the Authorized Representative, or his/her designee, as collateral security for any or all of the Indebtedness, and to grant and execute renewals, extensions or modifications thereof, and to authorize the State Water Board to perform any act necessary to perfect security, including but not limited to filing a Uniform Commercial Code (UCC-1) lien with the Secretary of State;

5. RESOLVED FURTHER, that the Authorized Representatives or designee is, authorized to represent the Company in carrying out the Company’s responsibilities under the financing agreement, including certifying disbursement requests on behalf of the Company and compliance with applicable state and federal laws;

6. RESOLVED FURTHER, that the Secretary of this Company is authorized to certify to the State Water Board a copy of this resolution and the name and signature of the Authorized Representative hereby authorized to act hereunder, and the State Water Board is hereby authorized to rely upon such certificate until formally advised by a like certificate of any change therein, and is hereby authorized to rely on any such additional certificates; and

7. RESOLVED FURTHER, that the authority granted hereunder shall be deemed retroactive.

All acts authorized hereunder and performed prior to the date of this Resolution are hereby ratified and affirmed. The State Water Board is authorized to rely upon this Resolution until written notice to the contrary, executed by the Board of Directors, is received by the State Water Board. The State Water Board shall be entitled to act in reliance upon the matters contained herein, notwithstanding anything to the contrary contained in the formation documents of
the ___________________________________________________________or in any other document.
(Applicant entity’s legal name)
PASSED AND ADOPTED this ___ th day of ________, 20___, by the following vote:

AYES: _____________________________________
[Full names of Board Members]
NOES: _____________________________________
[None or full names of Board Members]
ABSTAIN: _____________________________________
[None or full names of abstaining Board Members]
ABSENT: _____________________________________
[None or full names of Board Members]

CERTIFCATION
I, ________________, do hereby certify that I am the duly elected and qualified Secretary and the keeper ofthe records and corporate seal of _________________ , a corporation organized and existing under the laws of the State of California (the “Company”), and that the foregoing is a true and correct copy of Resolution No. ______ duly adopted by the Board of Directors of said Company at the Regular Meeting of said Board held on the ____th day of ____________ 20___, in accordance with law and the by- laws of the Company, and that such resolutions are now in full force and effect, unamended, unaltered and unrepealed.

Drinking Water State Revolving Fund
Attachment G13
Financial Assistance Application
(Rev. 05/2024)
I FURTHER CERTIFY THAT the following person has been duly appointed or elected and is now acting as officer or employee of the Company in the stated capacity:
__________________________ ________________________ __________ __________________ (Print Name) (Title) (Date) (Signature)
__________________________ ________________________ __________ __________________ (Print Name) (Title) (Date) (Signature)
__________________________ ________________________ __________ __________________ (Print Name) (Title) (Date) (Signature)
IN WITNESS WHEREOF, I have subscribed my name as Secretary as of_______________ 20 . (Date)
___________________________________
[Signature]
___________________________, Secretary
[Name]
_________________________, a California corporation
[Applicant’s entity’s legal name]

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Technical Application Instructions (Construction)
The Technical Package is intended to provide detailed technical information about the project. The Technical Package must include a complete Engineering Report stamped by a professional engineer, registered in the State of California. In addition, the applicant should provide a complete Technical, Managerial, and Financial (TMF) Assessment, an engineering services contract, and appropriate Plans and Specifications.

This section provides information on how to complete the Technical Package.

Applicant Name – Enter the entity that will be the legal signatory to a financing agreement.

Project Name – Enter the project name. This should match that on the California Environmental Quality Act (CEQA) documents, resolution, and any other existing documents.

Water System Number – Enter the seven-digit number assigned to your drinking water system. You can visit Drinking Water Watch to obtain the number for your water system: https://sdwis.waterboards.ca.gov/pdww/.

Type of Project – Check all project types that apply. If you select “other,” you must enter a description in the space provided.

Section I – Technical Information
Engineering Report (Attachment T1) – The applicant must submit an Engineering Report appropriate to the project. The contents of the Engineering Report are intended to provide the Division with adequate information to evaluate whether the project is eligible for DWSRF financing, meets applicable technical requirements, and is likely to meet applicable objectives and standards. The Engineering Report must address the elements outlined in Section I, Item 1 of the Technical Package. This section provides guidance about each of the elements that must be included in the Engineering Report.

Executive Summary – Provide a clear and concise summary of the Engineering Report. The summary should include but is not limited to the purpose of the project, key results of the alternative analysis, financial implications, and other essential project information.

Background Project Information – Provide background information regarding the proposed project.

1. Describe the Existing Facilities
a. The Engineering Report must include a description of the water system and its facilities, including details relating to sources, storage, treatment, and distribution. Describe the water system’s present condition, suitability for continued use, adequacy of water supply, current water system capacity, age of facilities, and water quality. b. Attach a schematic and map of the water system. The schematic and map must include all the water system’s facilities, including the facilities described in subsection 1.a above. The schematic and map must be legible. You may include photographs and sketches as needed.

2. Provide an analysis of the water system’s current water demand. You must provide a description of the methodology used to determine the water system’s demand. The analysis should include but may not be limited to maximum daily demand (MDD), fire flow, water demand resultant from growth, and peak hourly demand (PHD). The analysis should also describe how industrial and commercial water users impact the water demand.

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund

3. Describe existing water system Operations and Maintenance (O&M) practices. Describe how these practices impact the water system’s finances. Describe any financial or technical challenges that may impact water system operations and state any preventive practices that are in place to address these challenges.

Problem Description – Describe the problem being addressed by the project and attach documents supporting the ranked problem, including but not limited to the last two years of water quality data, most recent compliance orders, violations, citations and sanitary surveys. If the Compliance Order is related to a Maximum Contaminant Level (MCL) exceedance, identify the contaminant. For any small water systems or systems serving solely schools, the problem description should also identify any capital improvement needs to comply with Section 10609.62 of the Health and Safety Code which outlines drought resiliency requirements.

Consolidation Analysis – A consolidation evaluation must be included in the Engineering Report. The DWSRF Policy requires all funding applicants to evaluate the feasibility of consolidation as an alternative solution. If consolidation is deemed infeasible, the applicant must fully and completely discuss the reasons for that determination. Supporting information justifying the decision is required. Guidelines for consolidation projects are available on the State Water Board’s website:
https://www.waterboards.ca.gov/drinking_water/services/funding/documents/srf/dwsrf_policy/appendix_a.pdf.

Alternative Analysis – Describe each alternative considered to correct the problem stated in Section B.

As required in the DWSRF Policy, you must include the feasibility of consolidating with one or more water systems as one of the alternatives considered. The selected construction project must be the most cost effective, long-term solution. The alternative analysis must address the following items for each alternative considered.

1. Description – Describe all the facilities associated with the alternative. The description must be full and complete, including all necessary details pertinent to the proposed design.

2. Design criteria – State the design parameters and assumptions used in the evaluation.

3. Environmental impacts – Provide a short description of any environmental impacts that may prevent the alternative from being considered.

4. Land requirements – Identify sites and easements required to implement the alternative. Specify whether or not these properties are currently owned, currently leased, or if either the property or lease needs to be acquired prior to implementing the alternative.

5. Construction and site considerations – Discuss any concerns that may adversely affect the construction cost or facility operations. The concerns may include issues like site conditions, water table level, access to premises, or vulnerability to climate change effects.

6. Cost estimate – Include cost estimates for each of the alternatives considered. This section should include the following information. This information should be used in conjunction with the information above to determine the most cost-effective alternative. a. Construction
b. Non-construction and other related costs
c. Annual operations and maintenance costs
d. Cost effective present worth analysis
e. Life-cycle cost analysis

7. Advantages/Disadvantages – Describe the alternative’s advantages and disadvantages relating to its ability to comply with regulatory requirements, meet the water system’s O&M needs, be financially viable, satisfy public concerns, and meet environmental requirements.

8. Alternative Evaluation and Selection – Evaluate the alternatives based on the selection criteria.

Describe the selection of the most suitable alternative for the project.

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
Selected Project – It is expected that a single alternative be selected based on the alternative analysis described above. Once selected, additional information should be provided regarding the selected project.

The fully described selected project should include the following items.

1. Description – Describe all of the facilities associated with the selected project. This description should incorporate all components of the selected project and may be more detailed than the description provided in the alternatives analysis.

2. Schematic and map of system’s proposed facilities – Attach a schematic and map of the system which includes the proposed facilities as described above.

3. Justification – Describe how this project will solve the problem and provide an analysis of its effectiveness. The justification for the selected project should address its advantages over the other alternatives and state why it is the most cost-effective solution.

4. Describe O&M challenges that the selected project may encounter and describe the proposed solutions needed to meet these challenges, including roughly estimating household rate increases likely to result from any significant increases in O&M costs associated with the project compared to existing.

5. Determine if the project is consistent with local/county planning. List the local/county planning documents used to make such determination.

6. Describe if this project includes any green and resilient components and include cost estimate.

Resilience looks to the future rather than the immediate delivery of assistance to a system following an extreme event. “Green” projects as defined by Congress translate to active conservation of resources.

For further information, refer to the Drinking Water State Revolving Fund Eligibility Handbook:
https://www.epa.gov/sites/production/files/2017-
06/documents/dwsrf_eligibility_handbook_june_13_2017_updated_508_version.pdf.

7. If the selected project is a consolidation project, list all parties involved and identify the restructuring water system that will remain after the project is complete. A Supplemental Information Form for Consolidation (Appendix A located at:
https://www.waterboards.ca.gov/drinking_water/services/funding/documents/srf/dwsrf_policy/appendix_ a.pdf) for each involved water system must be submitted with the application.

8. List any land that will need to be purchased or acquired to complete the construction project. Discuss the necessity for such land and justify the appropriateness of the size of the land being purchased. (NOTE: Only land or land access that is integral to the construction of source, treatment or distribution facilities is eligible for DWSRF funding.)

9. Describe final Plans and Specifications as well as other technical aspects of the project, including the overall conceptual design (e.g. layout, flow diagrams, choice of unit processes, redundancy, reliability features). If plans and specifications are available, include as an attachment.

10. Provide water demand and capacity analysis for the water system that includes the existing facilities and selected project. The analysis should include but may not be limited to max daily demand, fire flow, water demand resultant from growth, and peak hourly demand. The analysis should also describe how industrial and commercial water users impact the water demand.

Projects financed by the DWSRF:
a. Must be sized to meet existing Maximum Day Demand (MDD) b. May be sized to include the design capacity needed to meet the fire protection requirement of the local fire authority, and
c. May include the design capacity needed for a reasonable amount of population growth expected to occur over a twenty-year period, if documentation is submitted to support the need.

The combined capacity of a, b, and c generally equates to the eligible capacity of a DWSRF funded project. Refer to Appendix H of the DWSRF Policy, located at

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
https://www.waterboards.ca.gov/drinking_water/services/funding/documents/srf/dw_capacity_limitations _final.pdf for additional guidance.

11. Estimated Useful Life – List all major project components and identify their estimated useful life.

Describe the basis for determining the useful life of each component.

Detailed Cost Estimate for the selected project – Attach a detailed cost breakdown for the project which lists: all major construction components, non-construction costs, operation and maintenance, and ineligible items.

Proposed Schedule – Include a project schedule. Construction projects are required to be completed no later than three years from the funding agreement execution date.

Schematic and map of system’s proposed facilities – Include a schematic and map of the proposed project that show all the facilities of the project described above.

Comprehensive Response to Climate Change – Include a detailed description on climate change preparedness. Provide detailed description on vulnerability, adaptation, and mitigation.

1. Vulnerability – Provide a detailed description of all effects of climate changes that the proposed facilities are susceptible to. Include critical threshold conditions that may cause damage to the facility or result in loss of services.

2. Adaptation – Provide a detailed description of all applied adaptation measures considered by the applicant. Include adaptation measures deemed unnecessary and explain why such measures were eliminated.

3. Mitigation – Provide a detailed description of all mitigation measures considered by the applicant.

Include mitigation measures deemed unnecessary and explain why such measures were eliminated.

4. Definitions – Climate change vulnerability, mitigation, and adaptation are defined below:
a. Vulnerability: This term is used to identify effects of climate change that the facility may be susceptible to. Some effects overlap. For example, a treatment facility built on the coast may be severely vulnerable to sea level rise. It would be a poor investment for the State to invest in a treatment facility with an expected useful life of 50 years when the facility is projected to be under water in 20 years due to sea level rise. Coincidentally, as sea level rises, the neighboring groundwater aquifers may be vulnerable to saltwater intrusion and water quality issues. The two effects are related, and both should be discussed in the attachment. Other examples of vulnerability include, water supply depletion, adverse water supply quality, flooding/storm surges, drought, and wildfires.
b. Adaptation: This term is used to identify measures taken as a direct response to climate change effects. Multiple measures can be taken in response to a single vulnerability. For example, in response to sea level rise an agency may investigate constructing sea walls or levees in order to prevent flooding. Flood contingencies should also be explored to protect the facility if the levees fail or in the event of severe storm surges.
c. Mitigation: This term is used to identify measures taken to slow or stop changes caused by greenhouse gas emissions in the atmosphere. Measures identified in adaptation may also be used for mitigation. For example, water conservation may be an adaptation response to drought vulnerability but a mitigation measure by reducing the energy consumed to move excessive volumes of water. Green roofing as an adaptation measure will help to reduce the heat island effect of an urban community, and as a mitigation measure will reduce the energy consumed to heat and cool the building.

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
Greenhouse Gas (GHG) Reduction Efforts – Provide a detailed description of any project components that reduce GHG emissions (e.g. solar photovoltaic (PV) electricity, replacing existing pumps with a more energy efficient electric pump, variable frequency drive (VFD) on a pump motor to better match output needs and improve pump efficiency, energy efficiency retrofits, and/or water saving, etc. ) Copy of any permits required as part of this project – Attach permits required as part of this project.

This may include, but not limited to, water system permit, water rights permits, etc.

Supplemental Information Form (Consolidation Projects Only) – Consolidation project applicants must submit a Supplemental Information Form. The form is available as the attachment to the Policy, ‘Guidelines for Consolidation Projects’:
https://waterboards.ca.gov/drinking_water/services/funding/documents/srf/dwsrf_policy/appendix_a.pdf Technical, Managerial, and Financial (TMF) Assessment (Attachment T2) – Federal law states that the DWSRF can only fund water systems that demonstrate that they have adequate TMF capacity to operate a public water system satisfactorily. The mandatory TMF elements listed on the TMF Assessment Form must be submitted (Attachment T2). Any unaddressed Necessary TMF elements will be listed as financing agreement conditions with the expectation that they be completed prior to project completion. If you need assistance in completing the TMF Assessment Form, please contact the Division of Drinking Water District Office that regulates your water system.

The State Water Board can provide technical assistance to small water systems serving populations less than 10,000 and disadvantaged communities in developing the TMF documents. A disadvantaged community is defined as the entire service area of a community water system in which the median household income is less than eighty percent (80%) of the statewide median household income. Upon receiving such a request, engineers from the District Office or a third-party contractor hired by the State Water Board will visit the water system and provide “hands-on” technical assistance in developing the necessary documents at no cost to the applicant. For more information go to the State Water Board’s Website:
https://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/TMF.html Professional Engineering Services Contract (Attachment T3) – Attach a copy of the professional engineering services contract for each engineering consultant contracted for the project. The professional services contract will form the basis for reimbursement of costs incurred relating to the project. Lack of supporting documentation may result in a denial of the claim. California Law requires that a professional engineer utilize a written contract when providing professional engineering services. The contract must be executed by both the professional engineer and their client prior to commencing the work. California law requires that the written contract for engineering services must include, but not limited to, all of the following:

1. A description of the services to be provided by the professional engineer

2. A description of any basis of compensation applicable to the contract, and the method of payment agreed upon by the parties

3. Name, address, and license or certificate number of the professional engineer, and the name and address of the client

4. A description of the procedure that the professional engineer and the client will use to accommodate additional services

5. A description of the procedure to be used by any party to terminate the contract A written contract for engineering services should also include a scope of work, costs, and deliverable due dates.

Plans and Specifications (Attachment T4) – Attach a copy of the final Plans and Specifications, which will be used as the basis of the construction contract. The Plans and Specifications must comply with state and federal regulations.

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
Section II – Project Summary
Include a clear and concise project summary. You may use the Engineering Report’s executive summary.

Section III – Water Rights (Attachment T5)
Description of Water Rights – Describe the nature of the water rights applicable to your water source.

Discuss the status of any existing or proposed water acquisitions. Attach water rights documentation related to your water source associated to the project. This may include documents such as permits, licenses, letters of authority, or other agreements showing all water rights owned or controlled by the system.

If you have questions regarding whether a petition is required you may contact the Division of Water Rights at (916) 341-5300 or [email protected].

1. Description of Water Rights – Surface Water
If the water source for this project is surface water, indicate whether the source of the water is a stream or other surface water body, or subterranean stream flowing through a known and definite channel to another location. If the applicant holds sufficient water rights for the project, provide a copy of water rights and label as Attachment T5. Indicate whether the applicant holds an Appropriative or Riparian water right, Refer to the State Water Board’s Water Rights website for further details:
https://www.waterboards.ca.gov/waterrights/board_info/water_rights_process.shtml#law. • Appropriative – If the applicant has an appropriative water right, indicate whether it is a Pre-1914 or a permitted/licensed water right. If Pre-1914, provide a statement that water rights were established prior to 1914, and enter the statement number in the file provided in the construction application. If after 1914, provide a copy of the SWRCB water rights permit or license, and enter the permit or license number provided in the construction application.
• Riparian – Provide a statement that water is derived from a surface source pursuant to a riparian right and include a map showing location relative to extraction point.

2. Description of Water Rights – Groundwater
If the water source for this project is groundwater, indicate whether the source is an unadjudicated or adjudicated source.
• Unadjudicated Basin: Provide a statement that the groundwater is extracted from a basin that is not adjudicated. Provide copies of the deeds for the parcels of each unadjudicated groundwater source used by the system.
• Adjudicated Basin: Attach the deed for the parcels of each adjudicated groundwater source that notes the adjudication or provide documentation of the Basin Water Master’s terms of the adjudication as they relate to the water system’s right to extract water from the adjudicated basin.

3. Description of Water Rights – Purchased Water
Provide a copy of the water service agreement for purchased water that specifies the duration of the authorization. Be aware that for SWRCB funded projects the long-term use agreements for purchased water must extend for the life of the loan or a minimum of 20 years for grant funded projects. In the construction application, enter the name of the wholesaler and length of the purchasing agreement.

Water Diversion Reporting – Check () the box indicating if you are a water diverter in compliance with Water Code Section 5103. For information see:
https://www.waterboards.ca.gov/waterrights/water_issues/programs/diversion_use/

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
Section IV – Comprehensive Response to Climate Change
The purpose of this section is for the applicant to identify how the proposed facility is vulnerable to the effects of climate change and the impacts the facility may have on the climate. Investigation into adaption and mitigation measures that lead to responsible resolutions made by the agency will ultimately improve the investments made by the State. Select all boxes applicable to the facility regarding climate change vulnerability, and all boxes considered by the applicant regarding adaptation and mitigation. Each section includes an “Other” box followed by an area to define the unnamed option. Information provided in this section must be supported by the information provided in the Engineering Report.

Section V – Drought Planning
Check () the box indicating if you are a Small Water Supplier or Non-Transient Non-Community Water System in compliance with California Water Code Section 10609.60 through Section 10609.63.

Check () the box indicating if this project includes components to come into compliance with California Water Code Section 10609.60 through Section 10609.63.

For information see: https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB552 Provide supporting documentation for all compliance, deficiencies, and plans to comply. (Attachment T6) Section VI – Attachment Checklist
All attachments must be submitted to consider this application package complete. Below is a list of the required attachments:

T1 – Engineering Report
T2 – TMF Assessment Form
T3 – Professional Engineering Services Contract
T4 – Plans and Specifications
T5 – Water Rights Documentation
T6 – Documentation for Compliance with Drought Planning

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund

TECHNICAL PACKAGE (CONSTRUCTION)
It is important that you read and understand the Application Information and Instructions before you complete this application. Submit this application along with required attachments through the Financial Assistance Application Submittal Tool (FAAST). All fields are required.

Applicant (Entity) Name:

Project Name:

Water System Number:

Type of Project: ☐ Treatment ☐ Distribution/Transmission ☐ Water Supply ☐ Water Shortage ☐ Other I. TECHNICAL INFORMATION

1. Attach a complete Engineering Report (label as Attachment T1) stamped by a registered Professional Engineer.

2. Attach a copy of the Technical, Managerial, and Financial (TMF) Assessment Form (label as Attachment T2).

3. Attach a copy of the applicable contract for professional engineering services (label as Attachment T3).

4. Attach a copy of Plans and Specifications (label as Attachment T4).

II. PROJECT SUMMARY

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
III. WATER RIGHTS
DESCRIPTION OF WATER SOURCE (label as Attachment T5):

1. Surface Water – Is the source of water for this project a stream or other surface water body, or subterranean stream f lowing through a known and definite channel to another location? ☐No (If No, proceed to question 2.)
☐Yes - If Yes,
a. Does the entity currently hold sufficient water rights for the project? ☐Yes – Provide a copy of the water right(s) (label as Attachment T5). ☐No – Proceed to question 1.b and 1.c.
b. If a new water right permit is required, has an application for a water right been filed with the State Water Board, Division of Water Rights?
☐Yes – Provide a copy of the water right application (label as Attachment T5).

Provide the status of the Petition for Change or the Order Number and Date of the Order Approving the Change:
☐No – Provide the date you anticipate submitting the water right application:
☐N/A
c. Is a change to a water right or transfer required to implement the project, and has a Petition for Change been filed with the State Water Board, Division of Water Rights? ☐Yes – Provide a copy of the Petition for Change (label as Attachment T5). ☐No – Provide the date you anticipate submitting the Petition for Change:

2. Groundwater – Is the groundwater an adjudicated or unadjudicated source?
☐Unadjudicated (Provide documentation and label as Attachment T5). ☐Adjudicated (Provide documentation and label as Attachment T5).

3. Purchased Water – Is the water for this project purchased? ☐Yes ☐No (If Yes, provide purchasing agreement and label as Attachment T5).

Name of Wholesaler:

What is the length of purchasing agreement?

WATER DIVERSION REPORTING
Are you a water diverter in compliance with Water Code Section 5103? ☐Yes ☐No
For information see: https://www.waterboards.ca.gov/waterrights/water_issues/programs/diversion_use/

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
IV. COMPREHENSIVE RESPONSE TO CLIMATE CHANGE
Identify how the current water system facilities are vulnerable to climate change and the potential impact the proposed project may have on climate change. (Detailed study, analysis, and description to be included in this project as part of the engineering report.)

1. Vulnerability – Identify effects of climate change to which the facility may be susceptible ☐Sea Level Rise ☐Water Supply Depletion ☐Water Supply Quality ☐Flooding/Storm Surges ☐Forest Fires ☐Drought
☐Other (Explain below):

2. Adaptation – Identify Measures taken in response to climate change. ☐Alternative Energy Sources ☐Drought Resiliency and Flood Contingency ☐Permeable Pavements ☐Elevated construction, Sea Walls, and Levees ☐Green Roofing ☐Fire Resistant Water Connections and Hydrants ☐Other (Explain below):

3. Mitigation – Identify Actions taken to reduce concentration of greenhouse gases in the atmosphere. ☐Renewable Energy Sources ☐Energy Conservation
☐Water Conservation
☐Other (Explain below):

V. DROUGHT PLANNING
As applicable, are you a Small Water Supplier or Non-Transient Non-Community Water System in compliance with Water Code Section 10609.60 through Section 10609.63? ☐Yes ☐No ☐N/A (Skip this section) Does this project include components to come into compliance with California Water Code Section 10609.60 through Section 10609.63. ☐Yes ☐No ☐N/A
For information see: https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB552 Provide supporting documentation for all compliance, deficiencies, and plans to comply (Label as Attachment T6)

Financial Assistance Application
(REV. 05/2024)

Drinking Water State Revolving Fund
VI. ATTACHMENT CHECKLIST
Check the box next to each item attached to your application and refer to application instructions to ensure completeness of application.
☐T1 – Engineering Report
☐T2 – TMF Assessment Form
☐T3 – Professional Engineering Services Contract
☐T4 – Plans and Specifications
☐T5 – Water Rights Documentation
☐T6 – Documentation for Compliance with Drought Planning

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 1 Environmental Package (Rev. 2/2024)

DRINKING WATER ENVIRONMENTAL PACKAGE INSTRUCTIONS
(CONSTRUCTION – TIER I)
This Environmental Package is required for projects undergoing a Tier I (i.e., “equivalency”) review under the current Drinking Water (DW) State Revolving Fund (SRF) Intended Use Plan.

For additional information on the Tier I process, see the Drinking Water State Environmental Review Process. The DW SRF Intended Use Plan can be found here:
https://www.waterboards.ca.gov/drinking_water/services/funding/DWSRFIUP.html.

If you are not certain whether to complete this Tier I Environmental Package or the Tier II Environmental Package, contact the assigned State Water Resources Control Board (State Water Board) Project Manager. If a Project Manager has not been assigned to the project, contact the State Water Board, Division of Financial Assistance [[email protected]; (916) 327- 9978].

I. GENERAL INFORMATION
Applicant (entity) name: Enter the full name of the entity that will be the legal signatory to a financing agreement.

Project title: Enter the title of the project.

Environmental documents prepared by (e.g., consultant, city, etc.): Provide the name of the environmental consulting firm, company, entity, or public agency that prepared the environmental document(s).

Environmental contact (e.g., consultant, city, or county staff, etc.): Provide the name of a person that prepared the environmental documents for the project, and/or is knowledgeable about the environmental documents. A State Water Board Environmental Scientist may need to coordinate with this contact person during the environmental review process.

Contact email: Provide an email for the listed environmental contact.

Contact phone: Provide a phone number for the listed environmental contact.

Project description: Provide a description of all anticipated construction activities or indicate where this information may be found.

List and describe all environmental permits, approvals, and/or certifications required for the project: Identify any permits, approvals, and/or certifications that are required for the project.

Permits, approvals, and certifications include those issued by local, state, and federal agencies, such as a California Department of Fish and Wildlife (CDFW) Lake and Streambed Alteration Agreement, Clean Water Act (CWA), Sections 404 Permit and 401 Certification, a Coastal Development permit, etc.

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 2 Environmental Package (Rev. 2/2024)
NOTE: Any project, regardless of funding, must obtain approval for any temporary or permanent disturbance to federal and state waters. The CWA, Sections 404 and 401 require consultation with the United States Army Corps of Engineers (USACE) and the Regional Water Quality Control Board(s) (RWQCB), if a project may result in the discharge of dredged or fill material into waters of the United States, including wetlands. The CWA, Section 404 Permit process through the USACE can be lengthy, and, as with the CWA, Section 401 Certification process, may ultimately require project alterations to avoid an adverse impact on waters of the United States. The applicant must consult with the USACE and the RWQCB(s) early in the planning process if any portion of the project may impact, or the project site contains waters of the United States, so that practical project alternatives and/or impact avoidance can be discussed. For more information on the CWA, Sections 404 Permit and 401 Certification processes, please visit https://www.epa.gov/cwa-404/section-404- permit-program and https://19january2017snapshot.epa.gov/sites/production/files/2016- 11/documents/cwa_401_handbook_2010.pdf.

II. CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA)
The CEQA process must be complete prior to a financing agreement being executed by the State Water Board, Division of Financial Assistance.

Title of CEQA document: Provide the title of the CEQA document that covers the project.

CEQA lead agency: Provide the name of the public agency acting as the lead agency pursuant to CEQA Guidelines. The CEQA lead agency is the public agency which has the principal responsibility for carrying out or approving the project.

If the applicant is not a public agency (e.g., non-profit, private water system, Native American Tribe, etc.), contact the State Water Board, Division of Financial Assistance to ensure CEQA requirements are met, and to assist in determining the lead agency for the proposed project.

If the State Water Board is the CEQA lead agency, early coordination with the State Water Board, Division of Financial Assistance is necessary to ensure Assembly Bill 52 tribal consultation requirements are met and to determine the appropriate CEQA process is completed. CEQA documents prepared for the State Water Board as CEQA lead agency must meet Web Content Accessibility Guidelines (WCAG) 2.1, with a minimum conformance level of AA. Additional information about WCAG 2.1 guidelines can be found at the World Wide Web Consortium website:
https://www.w3.org/TR/WCAG21/.

When the applicant is acting as a CEQA responsible agency, they must adopt/certify the CEQA document, approve the project, and file a Notice of Determination with the County Clerk and the Governor’s Office of Planning and Research (OPR), State Clearinghouse (SCH).

Office of Planning and Research (OPR), State Clearinghouse (SCH) number: Enter the ten-digit number assigned to the project at the time of filing with the OPR, SCH.

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 3 Environmental Package (Rev. 2/2024)
All CEQA documents with public comment period requirements must be circulated through the OPR, SCH. Additionally, to meet DW SRF requirements, all Notices of Exemption and Notices of Determination must be filed with the OPR, SCH in addition to the local County Clerk’s office.

Complete the appropriate CEQA checklist(s) below and provide any applicable documents as attachments to the Environmental Package. Some documents may fulfill multiple checklist items, for example, the CEQA lead agency may have adopted the final MND and the Mitigation Monitoring and Reporting Plan/Program in the same adoption resolution or meeting minutes.

Detailed information on CEQA requirements, including statutes and CEQA Guidelines, can be obtained at http://www.opr.ca.gov/ceqa/.

III. CEQA EXEMPTION INFORMATION

Complete this section only if the project is exempt from CEQA.

All CEQA exemptions, including statutory exemptions, under both Tier I and Tier II are subject to the CEQA exceptions (see Attachment 7 of the Drinking Water State Environmental Review Process; 40 CFR 35.3580(e), which prohibit application of exemptions where there are extraordinary circumstances in which a normally excluded project may have a significant environmental effect).

Identify the CEQA exemption(s) that applies to the project: Identify the California Code of Regulations citation(s). See Attachment 7 of the Drinking Water State Environmental Review Process.

Justify why the exemption(s) applies to the project: Write a brief statement justifying why the exemption(s) applies to the project. This can be the same statement included on the NOE.

If applicable, list any documents that support the CEQA exemption(s) applied to the project:

Provide the title of any document(s) used to support the CEQA exemption(s) applied to the project, and submit a copy of the document(s) as an attachment to the Environmental Package (e.g., documentation explaining why exceptions to the categorical exemptions do not apply, technical reports, Initial Studies, maps, photographs, etc.).

If the project is categorically exempt, respond to the following exceptions and justify why each exception (identified in the California Code of Regulations, title 14, division 6, chapter 3, article 19, section 15300.2.) does not apply. The California Code of Regulations identifies six exceptions to categorical exemptions, which may cause a categorical exemption to not apply to a project. If a categorical exemption applies to the project, justify why each of the six exceptions listed do not apply, or indicate where this information may be found and attach supporting documentation to the Environmental Package. Note that the first exception (location) is only relevant if a class 3, 4, and/or 6 categorical exemption applies. If the project is exempt from CEQA but a categorical exemption does not apply, no response is required for the exceptions.

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 4 Environmental Package (Rev. 2/2024)
IV. FEDERAL ENVIRONMENTAL REQUIREMENTS AND DOCUMENTATION The applicant should discuss in detail the steps taken to meet the federal environmental regulations identified in this Environmental Package, including cross-cutting federal environmental requirements, and provide appropriate supporting information. Supporting information must be uploaded to FAAST labeled E2 “Document Type” (e.g., E2-Air Quality Estimates, E2-Biological Assessment, etc.). Please contact the Environmental Review Staff (refer to contact list for the Division of Financial Assistance Environmental Section at
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/environmental_requirements.ht ml) for questions regarding environmental requirements.

Federal Environmental Requirements Affecting CEQA Documents Projects applying for DW SRF financing that are undergoing a Tier I review must meet the requirements of the 40 Code of Federal Regulations, section 35.3580 (https://www.ecfr.gov/current/title-40/chapter-I/subchapter-B/part-35/subpart-L/section-35.3580), which includes requirements that may not be included in the California Code of Regulations, CEQA Guidelines. Certain requirements therefore apply to CEQA documents that are not normally necessary per the CEQA Guidelines (e.g., public circulation of addendums, environmental alternative analysis for projects covered under an ND or MND, etc.).

The following sections outline the additional requirements that apply to certain documents and steps of the CEQA process.

Public hearing and meeting requirements. A public hearing or meeting must be held for all projects and activities except those having little or no environmental effect. Projects exempt from CEQA, and many projects covered by an MND or ND may qualify as having little or no environmental effect, and thus would not require a public hearing or meeting. Public hearings or meetings to adopt an ND or MND, or to certify a final EIR will meet this requirement. The applicant should consult with the Environmental Review Staff to determine whether a public hearing or meeting is required. If a public hearing or meeting is determined by the Environmental Review Staff to be necessary, or one has already occurred for other reasons, provide the date(s) of when any such meeting(s) was held.

Formal public comment period for projects with scope changes. For certain projects where the project scope changed after the adoption of the original CEQA document, the lead agency must provide a formal public comment period during which time no action on a project will be allowed. If a supplemental or subsequent ND/MND/EIR is required, CEQA specifies the required public comment period, however CEQA does not specify a public comment period for addendum. For most projects involving an addendum and where the underlying CEQA document has already undergone a public comment period, the State Water Board will not require the addendum to be posted for public comment. However, the Environmental Review Staff may require circulation of an addendum for public comment through the OPR, SCH if an addendum is prepared due to changes in the project scope or other factors (e.g., legal challenges, public concerns) that warrant additional public participation.

For an addendum that must be circulated through the OPR, SCH, no minimum circulation length is required. Filing an NOD after the addendum is circulated and considered by the decisionPage 166 of 349

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 5 Environmental Package (Rev. 2/2024)
making body of the lead agency consistent with the CEQA Guidelines, section 15164 is recommended, but not required.

The applicant should consult with the Environmental Review Staff to determine whether a public comment period for an addendum is necessary.

Five-year reaffirmation requirements. For projects where the environmental document was adopted more than five years prior to the approval of financing, reevaluation of the project is required. Therefore, CEQA documents for projects must be adopted or certified and NOEs signed fewer than five years from the execution of the funding agreement. For projects that do not meet this requirement, if appropriate, the applicant must prepare a memorandum affirming that the previously prepared environmental evaluation and the resulting environmental document still apply to the project. The memorandum must be signed and approved by the applicant’s authorized representative. If the project scope has changed, the applicant must prepare an addendum, supplemental or subsequent CEQA document, or file a new NOE consistent with the CEQA Guidelines to meet this requirement.

Attach the following documents to the Environmental Package:

1. A copy of the five-year reaffirmation memorandum signed by the applicant’s authorized representative (if applicable).

Environmental Analysis of Alternatives requirements. The DW SRF Program requires an environmental analysis of alternatives for projects that are not exempt from CEQA. Preparation of an Environmental Impact Report under CEQA typically meets this requirement.

If a Negative Declaration or Mitigated Negative Declaration (ND/MND) was prepared for the project, briefly discuss the “No Project” alternative if this is not already included in the ND/MND. (For general guidance, see CEQA Guidelines, section 15126.6(e)). If project alternatives beyond the selected project were considered but are not included in the CEQA document, briefly discuss, or identify the document that discusses the alternative analysis.

Federal Co-Funding Sources
Will the project potentially be co-funded by one or multiple other federal agencies? Indicate if the project will potentially receive funding from any other federal agencies. If the project will potentially be funded by any other federal agencies, respond to list items a-c by listing the agencies, explaining the funding status, and providing the contact information for the federal agency representative with whom the applicant has been in contact.

If more than one (1) federal agency is involved in a project, the agencies will need to coordinate to determine who will be the federal lead agency when conducting consultations (e.g., Section 7 of the Endangered Species Act and Section 106 of the National Historic Preservation Act).

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 6 Environmental Package (Rev. 2/2024)
Federal Lands
Is any portion of the proposed project site located on federally managed land, such as United States Forest Service (USFS) or Bureau of Land Management (BLM) land? Indicate if any portion of the proposed project is located on federally managed land, including USFS, BLM, or land managed by any other federal agency. If yes, respond to list items a-e.

Information and resources:

United States Department of Agriculture (USDA) United States Forest Service (USFS) Pacific Southwest Region website: http://www.fs.usda.gov/r5
USFS offices contact information website: https://www.fs.usda.gov/main/r5/about-region/offices United States Department of the Interior Bureau of Land Management (BLM) website:
https://www.blm.gov/california
BLM District Offices contact information website: https://www.blm.gov/office/california-state-office Interactive map of federally managed land: https://www.blm.gov/maps/frequentlyrequested/california Attach the following documents to the Environmental Package:

1. A colored map identifying the project location with respect to the federal land.

2. A copy of the appropriate authorization/permit for the use of federal land (e.g., USFS SpecialUse Authorization, BLM Land Use Permit) if one has been obtained.

Archaeological and Historic Preservation Act (AHPA)
Will the project cause the irreparable loss of or damage to a significant archaeological or historic resource or data through alteration of the terrain resulting from dam or reservoir construction (e.g., flooding, building of access roads, or construction of a reservoir)? Indicate if the project will cause irreparable loss of or damage to archaeological or historic resources or data through alteration of the terrain as a result of reservoir or dam construction (e.g., flooding, building of access roads, or construction of a reservoir). If yes, respond to item a.

Provide supplemental information as needed. The HPIR (see the National Historic Preservation Act below) will suffice as documentation for this requirement.

Information and resources:

United States Department of Interior National Park Service AHPA website:
https://www.nps.gov/archeology/tools/laws/AHPA.htm
Clean Air Act
Identify the air basin and local air district for the project area using the California Air Resources Board (CARB) Air Basin Map and the CARB Local Air District Map (or other resources as appropriate).

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 7 Environmental Package (Rev. 2/2024)
Is the project located in a nonattainment area, or an attainment area under a maintenance plan, for any criteria pollutant?
Indicate if the project is located in a nonattainment area, or an attainment area under a maintenance plan, for any criteria pollutant. If yes, respond to list items a-c. For list item b, provide the estimated project construction and operational air emissions (in tons per year) in the table [emissions can be estimated by using the California Emissions Estimator Model (CalEEMod):
https://caleemod.com/]. Local air quality thresholds of significance can be determined by contacting the Local Air District, or by visiting the Local Air District’s website.

For the DW SRF Program’s financed projects, we recommend the applicant include a General Conformity Determination section in the CEQA document(s), so that another public review process would not be needed, should a General Conformity Determination be required.

Information and resources:

United States Environmental Protection Agency (USEPA) Clean Air Act summary webpage:
https://www.epa.gov/laws-regulations/summary-clean-air-act California Air Resources Board (CARB) Air Basin Map:
http://www.arb.ca.gov/ei/maps/statemap/abmap.htm
CARB Local Air District Map: https://ww3.arb.ca.gov/capcoa/dismap.htm California Emissions Estimator Model (CalEEMod): https://caleemod.com/ Attach the following documents to the Environmental Package:

1. Any documents utilized to support the estimated emissions above, or to compile the air quality data (e.g., air quality studies/models, CalEEMod report) Coastal Barriers Resources Act
There are no designated Coastal Barrier Resource Systems in California. For more information on Coastal Barrier Resource Systems, please visit: http://www.fws.gov/CBRA/

Coastal Zone Management Act
Is any portion of the project site located within the coastal zone? Indicate if any portion of the project is located within the coastal zone. If yes, respond to list items a-c.

To help determine if the project is located within a coastal zone, please contact the city or county in which the project is located, or the local California Coastal Commission office (https://www.coastal.ca.gov/enforcement/cdp_pamphlet.pdf). California’s coastal zone is defined as extending seaward to the state’s outer limit of jurisdiction, including all offshore islands, and extending inland generally 1,000 yards from the mean high tide line of the sea. In significant coastal estuarine, habitat, and recreational areas, it extends inland to the first major ridgeline paralleling the sea or five (5) miles from the mean high tide line of the sea, whichever is less, and in developed urban areas the zone generally extends inland less than 1,000 yards. The coastal

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 8 Environmental Package (Rev. 2/2024)
zone for the San Francisco Bay Conservation and Development Commission (BCDC) includes the open water, marshes, and mudflats of the greater San Francisco Bay, and areas 100 feet inland from the line of highest tidal action. The BCDC boundary also includes: the Suisun Marsh and buffer zone: managed wetlands diked off from the Bay; and open waters diked off from the Bay and used in salt production.

Information and resources:

California Coastal Commission (CCC) maps: https://coastal.ca.gov/maps/ CCC coastal development permit information:
http://www.coastal.ca.gov/enforcement/cdp_pamphlet.pdf
CCC coastal development permit application and appeal forms: http://coastal.ca.gov/cdp/cdpforms.html San Francisco Bay Conservation and Development Commission website: http://www.bcdc.ca.gov/ California’s coastal zone generally extends 1,000 yards inland from the mean high tide line, but may extend further if the area is located in significant coastal estuarine, habitat, and/or recreational areas, or to a lesser extent if the area is located in a developed urban area or within a coastal zone of the San Francisco Bay Conservation and Development Commission. To help determine if the project is located within a coastal zone, please check the CCC jurisdictional maps or contact the local CCC office or the city or county in which the project is located.

Attach the following documents to the Environmental Package:

1. A copy of the coastal development permit or coastal exemption (if available) Endangered Species Act (ESA)
Does the project involve any direct or indirect impacts, from construction or operation activities, that may affect federally listed threatened or endangered species, or their critical habitat, that are known or have potential to occur on the project site, in the surrounding area, or in the service area?
Indicate if the project construction and/or operational activities may directly or indirectly affect any federally listed threatened or endangered species that are known or have a potential to occur on the project site, in the surrounding area, or in the service area. If no, explain the determination, or indicate where more information can be found (e.g., biological report/assessment, CEQA document, etc.). If yes, respond to list items a-f.

The applicant must provide a biological assessment/report, prepared by a qualified biologist, that addresses possible direct, indirect, and cumulative impacts of the project to federally listed species under the ESA. Biological assessments/reports must include a clear description of the project, construction information, an up-to-date field survey, a species assessment table for all federally protected species, and an analysis of impacts to those species that have the potential to occur within or adjacent to the project site. Species lists requested from the USFWS Information for Planning and Conservation database (https://ecos.fws.gov/ipac/) and the NMFS

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 9 Environmental Package (Rev. 2/2024)
(http://www.westcoast.fisheries.noaa.gov/maps_data/california_species_list_tools.html) must accompany the biological assessment/report, as well as recently-generated species lists from the CDFW California Natural Diversity Database (https://www.wildlife.ca.gov/Data/CNDDB) and the California Native Plant Society Inventory of Rare and Endangered Plants of California (http://www.rareplants.cnps.org/). If the applicant is unable to obtain an official NMFS species list, please contact the Environmental Review Staff for further assistance.

Information and resources:

USEPA Endangered Species Act Summary: https://www.epa.gov/laws-regulations/summaryendangered-species-act USFWS Section 7 Consultation: https://www.fws.gov/service/esa-section-7-consultation Refer to the following resources for information regarding possible biological impacts and to obtain official and unofficial species lists for analysis:

USFWS Information for Planning and Consultation (IPaC): https://ecos.fws.gov/ipac/ California Native Plant Society Inventory of Rare and Endangered Plants of California:
http://www.rareplants.cnps.org/
National Oceanic and Atmospheric Administration (NOAA) ESA consultation website:
https://www.fisheries.noaa.gov/topic/consultations#endangered-species-act-consultations California Department of Fish and Wildlife California Natural Diversity Database:
https://www.wildlife.ca.gov/Data/CNDDB
Attach the following documents to the Environmental Package:

1. A project-level biological report/assessment
Farmland Protection Policy Act
Is any portion of the project located on, or will the project impact prime, unique, or important farmland, or farmland under a Williamson Act Contract? Indicate if any portion of the project is located on or will impact prime, unique, or important farmland. If yes, respond to list items a-d. If the project area is protected farmland or farmland under the Williamson Act Contract, please consult with the appropriate federal, state, and local agencies, and provide necessary documents to the Division of Financial Assistance.

Information and resources:

USDA Farmland Protection Policy Act website: https://www.nrcs.usda.gov/conservationbasics/natural-resource-concerns/land/cropland/farmland-protection-policy-act California Department of Conservation California Important Farmland Finder:
https://maps.conservation.ca.gov/dlrp/ciff/

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 10 Environmental Package (Rev. 2/2024)
California Department of Conservation Farmland Mapping and Monitoring Program:
http://www.conservation.ca.gov/DLRP/fmmp/Pages/Index.aspx Attach the following documents to the Environmental Package:

1. Documents/assessments evaluating the conversion of prime/unique farmland and farmland of statewide/local importance to non-agricultural uses

2. Copies of any consultation(s) conducted with relevant agencies Floodplain Management: Executive Orders 11988, 12148, 13690, and 14030 Is any portion of the project located within a 100-year floodplain as depicted on an official floodplain map or otherwise designated by the Federal Emergency Management Agency (FEMA)?
Indicate if any portion of the project is located within a 100-year floodplain as depicted on a floodplain map or otherwise designated by the United States Department of Homeland Security, Federal Emergency Management Agency (FEMA). If yes, respond to list items a-c.

Information and resources:

Office of the Federal Register Executive Order 11988: https://www.archives.gov/federalregister/codification/executive-order/11988.html Office of the Federal Register Executive Order 12148: https://www.archives.gov/federalregister/codification/executive-order/12148.html Office of Federal Register executive Order 13690: https://www.gpo.gov/fdsys/pkg/FR-2015-02- 04/pdf/2015-02379.pdf
Executive Order Establishing a Federal Flood Risk Management Standard and a Process for Further Soliciting and Considering Stakeholder Input: https://www.whitehouse.gov/the-pressoffice/2015/01/30/executive-order-establishing-federal-flood-risk-management-standard-andFEMA Flood Map Service Center: https://msc.fema.gov/portal Attach the following documents to the Environmental Package:

1. An official floodplain map from the FEMA Flood Map Service Center that includes the project area (required for all projects)

2. Any reports (floodplains/hydrological assessment) completed for the project (if applicable) Magnuson-Stevens Fishery Conservation and Management Act Does the project involve any direct or indirect impacts from construction or operational activities, or changes in water quality/quantity, that may impact Essential Fish Habitat (EFH)?
Indicate if the project construction or operational activities involve direct or indirect impacts to Essential Fish Habitat (EFH). If yes, respond to list items a-c. To determine the project’s location

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 11 Environmental Package (Rev. 2/2024)
relative to designated EFH and to obtain an unofficial or official NMFS species list, consisting of both endangered species and EFH that could potentially occur in the project area, please visit:
http://www.westcoast.fisheries.noaa.gov/maps_data/california_species_list_tools.html. If the project may adversely impact EFH, the applicant must contact the NMFS to obtain an official species list. If the applicant is unable to obtain an official NMFS species list, please contact the Environmental Review Staff for further assistance.

Information and resources:

Refer to the NMFS EFH Mapper to help determine the project’s proximity and potential direct/indirect impacts to EFH, and to obtain a NMFS species list for the project location.

NMFS Essential Fish Habitat Mapper: https://www.fisheries.noaa.gov/resource/map/essential-fishhabitat-mapper NOAA Magnuson-Stevens Fishery Conservation and Management Act website:
https://www.fisheries.noaa.gov/resource/document/magnuson-stevens-fishery-conservation-andmanagement-act Attach the following documents to the Environmental Package:

1. An official copy of the NMFS species list, obtained through the NMFS Essential Fish Habitat Mapper
National Historic Preservation Act (NHPA)
A Historic Properties Identification Report (HPIR) is required for all projects undergoing a Tier I review unless the project is a type of activity that does not have the potential to cause effects to historic properties. Note that this is determined by the type of activities the project consists of, and not the impacts of the specific project. Generally, any project that includes groundbreaking activity has potential to cause effects to historic properties, and therefore an HPIR is required.

The HPIR must be written by a cultural resources professional who meets the Secretary of the Interior’s Professional Qualification Standards in Archaeology or Architectural History (https://www.nps.gov/articles/sec-standards-prof-quals.htm), as appropriate. The report must include a current records search (not older than five years) from the California Historical Resources Information System (CHRIS) (http://ohp.parks.ca.gov/?page_id=1068) extending to a half-mile beyond the project’s area of potential effects (APE), maps showing all recorded resources and surveys in relation to the APE, records of Native American outreach (http://nahc.ca.gov), and resource records from the CHRIS search and newly identified resources.

HPIRs should be prepared in accordance with the following guidelines:
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/docs/cultural_resources_rep ort_prep.pdf. The California Office of Historic Preservation website (under Section 106 Submission Checklists header) includes additional guidance regarding the information required to consult under Section 106 of the NHPA: http://ohp.parks.ca.gov/pages/1071/files/106Checklist_Details.pdf.

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 12 Environmental Package (Rev. 2/2024)
HPIRs may contain confidential information and should not be uploaded to the FAAST system; HPIRs should be submitted to the Senior Cultural Resources Officer whose contact information can be found at
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/docs/cultural_resources_rep ort_prep.pdf.

Identify Section 106 of the NHPA finding of effect contained in the cultural resources report:

Check the box that describes the Section 106 of the NHPA finding of effect contained in the HPIR.

If relevant, please justify compliance with the NHPA: If compliance with the NHPA has already been completed (e.g., another federal agency has already consulted under Section 106 of the NHPA for the project) explain that process here.

Provide a brief explanation for the above identified recommendation or indicate where this information can be found (e.g., HPIR or Cultural Report): Briefly explain why the Section 106 finding of effect applies to the project. If the project has no potential to cause effects to historic properties include a statement here about why this is the case.

Information and resources:

Advisory Council on Historic Preservation website: http://www.achp.gov/ Attach the following documents to the Environmental Package:

1. A HPIR, written by a cultural resources professional who meets the Secretary of the Interior’s Professional Qualification Standards in Archaeology or Architectural History (https://www.nps.gov/articles/sec-standards-prof-quals.htm), as appropriate. For detailed information on the contents of the report, visit
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/docs/cultural_resources_ report_prep.pdf. The HPIR must include all supporting documentation, such as the results of the CHRIS records search, the results of the Sacred Lands File Search and Native American correspondence, and site records from the records search and from new resources found during the field survey.

Protection of Wetlands
Will any portion of the project be located in or potentially affect a wetland? Indicate if any portion of the project is located in a wetland or if the project could potentially affect a wetland. If yes, respond to list items a-c. Explain if there is any area within the project boundaries that should be evaluated for wetland delineation and/or that requires a permit or certification from the USACE, RWQCB(s), and/or CDFW. A wetland delineation report must be prepared for any project that will be located in or will potentially impact a wetland.

Information and resources:

USEPA Protection of Wetlands Executive Order No. 119900 website:
https://www.epa.gov/cwa-404/protection-wetlands

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 13 Environmental Package (Rev. 2/2024)
USFWS National Wetlands Inventory Wetlands Mapper:
http://www.fws.gov/wetlands/Data/Mapper.html
USACE wetland assessment/delineation guidance:
https://www.codot.gov/programs/environmental/wetlands/documents/sacramento-districtminimum-standards-for-delineations-reports Attach the following documents to the Environmental Package:

1. A wetland assessment/delineation report consistent with the USACE guidance describing the project’s potential impacts to wetlands and/or potential wetland areas

2. Documentation on the avoidance, minimization, and conservation measures that will be implemented to reduce such impacts

3. A copy of the Clean Water Act Section 401 Certification (if available)

4. A copy of the Clean Water Act Section 404 Permit (if available) Safe Drinking Water Act/Sole Source Aquifer Protection
Is the project located in an area designated by the USEPA as a Sole Source Aquifer? Indicate if the project is located in an area designated by the USEPA, Region 9, as a sole source aquifer. Sole Source Aquifers in California, include the Fresno County Aquifer, Santa Margarita Aquifer, Campo/Cottonwood Creek Aquifer, and the Ocotillo-Coyote Wells Aquifer; see the USEPA interactive map for Sole Source Aquifers locations: https://www.epa.gov/dwssa. If yes, respond to list items a-b. The applicant must comply with the Safe Drinking Water Act and document whether or not the project has the potential to contaminate a Sole Source Aquifer. The applicant shall be held responsible for providing an alternate project location and/or appropriate mitigation measures if a Sole Source Aquifer were to be significantly impacted by a project.

Information and resources:

Sole Source Aquifers in California include the Fresno County Aquifer, Santa Margarita Aquifer, Campo/Cottonwood Creek Aquifer, and the Ocotillo-Coyote Wells Aquifer.

USEPA source water protection website:
http://water.epa.gov/infrastructure/drinkingwater/sourcewater/protection/index.cfm USEPA interactive map of Sole Source Aquifers: https://www.epa.gov/dwssa Attach the following documents to the Environmental Package:

1. A completed Sole Source Aquifer Project Review Information document (contact the Environmental Review Staff to request guidance)
Wild and Scenic Rivers Act
Identify the watershed within the project location by using the USEPA How’s My Waterway website: https://www.epa.gov/waterdata/hows-my-waterway Will the project impact any listed wild and scenic rivers?

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 14 Environmental Package (Rev. 2/2024)
Indicate if a segment of the project is located within and/or will impact a listed wild and scenic river. If yes, respond to list items a-c.

Information and resources:

Wild and Scenic Rivers in California include: Amargosa River, Lower American River, North Fork American River, Bautista Creek, Big Sur River, Black Butter River, Cottonwood Creek, Eel River, Feather River, Fuller Mill River, Kern River, Kings River, Klamath River Merced River, Owens River Headwaters, Palm Canyon Creek, Piru Creek, San Jacinto River (North Fork), Sespe Creek, Sisquoc River, Smith River, Trinity River, and Tuolumne River.

National Wild and Scenic Rivers System website: http://www.rivers.gov/california.php USEPA How’s My Waterway website: https://www.epa.gov/waterdata/hows-my-waterway Attach the following documents to the Environmental Package:

1. A map of the impacted wild and scenic river and the relative project location Federal Environmental Attachments
Complete the checklist indicating what federal documentation is being submitted attached to this Environmental Package.

Use the checklist to indicate what relevant federal documentation attachments are being submitted along with the completed Environmental Package.

Federal documentation may be necessary depending on the specific scope, location, and impacts of the project; refer to the individual cross-cutter sections above to determine if that specific cross-cutter applies to the project, and if additional documentation or information is required. Additional documentation and/or attachments may be requested based on the answers provided in this Environmental Package. If there are questions about required attachments, please contact the Environmental Review Staff:
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/environmental_requirements.ht ml.

A few attachments of note are the biological report/biological assessment for the Endangered Species Act, and the Historic Properties Identification Report for the National Historic Preservation Act. A biological report is generally required for most projects that may have potential to impact biological resources, especially those with potential to impact federally listed species. A Historic Properties Identification Report is generally required for all projects that include groundbreaking activity, even if the specific project does not have the potential to impact historic resources. If you are not sure whether these documents need to be submitted for a particular project, contact the Environmental Review Staff using the link above.

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 15 Environmental Package (Rev. 2/2024)
I. GENERAL INFORMATION
Applicant (entity) name:

Project title:

Environmental documents prepared by (e.g., consultant, city, etc.):

Environmental contact (e.g., consultant, city, or county staff, etc.):

Contact email:

Contact phone:

Project description:

List and describe all environmental permits, approvals, and/or certifications required for the project:

II. CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA)
Title of CEQA document:

CEQA lead agency:

If no public agencies have discretionary approval over the project other than the State Water Resources Control Board, contact the Division of Financial Assistance prior to development of any CEQA documentation (please see the Environmental Package Instructions above for additional information).

Office of Planning and Research (OPR), State Clearinghouse (SCH) number:

DRINKING WATER ENVIRONMENTAL PACKAGE
(CONSTRUCTION – TIER I)

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 16 Environmental Package (Rev. 2/2024)
Complete the appropriate CEQA checklist(s) below and provide any applicable documents as attachments to the Environmental Package.

CEQA Exemption
Required documents:

Notice of Exemption (NOE) filed with the local County Clerk - date filed:

NOE filed with the OPR, SCH - date filed:

Supporting documentation for categorical exemptions (if applicable) Initial Study/Negative Declaration (IS/ND)
Required documents:

Draft IS/ND circulated through the OPR, SCH
Comments received on circulated IS/ND
Responses to comments (if applicable)
Final IS/ND adopted by the CEQA lead agency
Resolution/meeting minutes adopting IS/ND - date adopted:

Notice of Determination (NOD) filed with the local County Clerk - date filed:

NOD filed with the OPR, SCH - date filed:

Initial Study/Mitigated Negative Declaration (IS/MND)
Required documents:

Draft IS/MND circulated through the OPR, SCH
Comments received on circulated IS/MND
Responses to comments (if applicable)
Final IS/MND adopted by the CEQA lead agency
Mitigation Monitoring and Reporting Plan/Program (MMRP) adopted by the CEQA lead agency Resolution/meeting minutes adopting IS/MND - date adopted:

Resolution/meeting minutes adopting MMRP - date adopted:

NOD filed with the local County Clerk - date filed:

NOD filed with the OPR, SCH - date filed:

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 17 Environmental Package (Rev. 2/2024)
Environmental Impact Report (EIR)
Required documents:

Draft EIR circulated through the OPR, SCH
Comments received on circulated EIR
Responses to comments
Final EIR certified by the CEQA lead agency
MMRP adopted by the CEQA lead agency
Statement of Overriding Considerations (if applicable) - date approved:

Resolution/meeting minutes certifying EIR - date certified:

Resolution/meeting minutes adopting MMRP - date adopted:

NOD filed with the local County Clerk - date filed:

NOD filed with the OPR, SCH - date filed:

Addendum/Addenda, Supplemental or Subsequent CEQA Document Required documents:

Addendum/Addenda, Supplemental, or Subsequent CEQA Document MMRP adopted by the CEQA lead agency (if applicable)
Resolution/meeting minutes/consideration document (if applicable) - date:

Resolution/meeting minutes adopting MMRP (if applicable) - date adopted:

NOD filed with the local County Clerk (if applicable) - date filed:

NOD filed with the OPR, SCH (if applicable) - date filed:

III. CEQA EXEMPTION INFORMATION
Complete this section only if the project is exempt from CEQA. All CEQA exemptions, including statutory exemptions, under both Tier I and Tier II are subject to the CEQA exceptions (see Attachment 7 of the State Environmental Review Process; 40 CFR 35.3580(e), which prohibit application of exemptions where there are extraordinary circumstances in which a normally excluded project may have a significant environmental effect).

Identify the CEQA exemption(s) that applies to the project:

Justify why the exemption(s) applies to the project:

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 18 Environmental Package (Rev. 2/2024)
If applicable, list any documents that support the CEQA exemption(s) applied to the project:

If the project is exempt, address the following exceptions and justify why each exception (identified in the California Code of Regulations, title 14, division 6, chapter 3, article 19, section 15300.2.) does not apply.

Location. Classes 3, 4, and 6 are qualified by consideration of where the project is to be located - a project that is ordinarily insignificant in its impact on the environment may in a particularly sensitive environment be significant. Therefore, these classes are considered to apply in all instances, except where the project may impact on an environmental resource of hazardous or critical concern where designated, precisely mapped, and officially adopted pursuant to law by federal, state, or local agencies.

If a class 3, 4, and/or 6 categorical exemption applies, justify why this exception does not apply to the project, and/or indicate where supporting information can be found:

Cumulative Impact. All exemptions for these classes are inapplicable when the cumulative impact of successive projects of the same type in the same place, over time is significant.

Justify why this exception does not apply to the project, and/or indicate where supporting information can be found:

Significant Effect. A categorical exemption shall not be used for an activity where there is a reasonable possibility that the activity will have a significant effect on the environment due to unusual circumstances.

Justify why this exception does not apply to the project, and/or indicate where supporting information can be found:

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 19 Environmental Package (Rev. 2/2024)
Scenic Highways. A categorical exemption shall not be used for a project which may result in damage to scenic resources, including but not limited to, trees, historic buildings, rock outcroppings, or similar resources, within a highway officially designated as a state scenic highway.

This does not apply to improvements which are required as mitigation by an adopted negative declaration or certified EIR.

Justify why this exception does not apply to the project, and/or indicate where supporting information can be found:

Hazardous Waste Sites. A categorical exemption shall not be used for a project located on a site which is included on any list compiled pursuant to Section 65962.5 of the Government Code.

Justify why this exception does not apply to the project, and/or indicate where supporting information can be found:

Historical Resources. A categorical exemption shall not be used for a project which may cause a substantial adverse change in the significance of a historical resource.

Justify why this exception does not apply to the project, and/or indicate where supporting information can be found:

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 20 Environmental Package (Rev. 2/2024)
IV. FEDERAL ENVIRONMENTAL REQUIREMENTS AND DOCUMENTATION

FEDERAL ENVIRONMENTAL REQUIREMENTS
Projects applying for Drinking Water (DW) State Revolving Fund (SRF) financing that are undergoing a Tier I review must meet the requirements of the 40 Code of Federal Regulations (CFR), section 35.3580, which includes requirements that may not be included in the California Code of Regulations, CEQA Guidelines. For additional information about these requirements refer to the Environmental Package Instructions above.

Public hearing and meeting requirements. A public hearing or meeting must be held for all projects except those having little or no environmental effect.

Provide the public hearing or meeting date(s), if applicable:

Formal public comment period for projects with scope changes.

Provide the public comment period date(s), if applicable:

Five-year reaffirmation requirements. If CEQA documents are adopted or NOEs are signed by the CEQA lead agency more than five years before approval of DW SRF financing, the lead agency must review whether the CEQA documents or NOEs are still applicable to the project, and if so, the lead agency must reaffirm the previously prepared environmental evaluation and resulting environmental document. If the applicant is the lead agency, submit a memorandum signed by the applicant’s authorized representative affirming that the previously prepared environmental evaluation and resulting environmental document still apply to the project.

Attach the following documents to the Environmental Package:

1. A copy of the five-year reaffirmation memorandum signed by the applicant’s authorized representative (if applicable)
Environmental Analysis of Alternatives. The DW SRF Program requires an environmental analysis of alternatives for projects that are not exempt from CEQA. Environmental Impact Reports must evaluate alternatives to the selected project to comply with CEQA. For projects covered by a Negative Declaration or Mitigated Negative Declaration (ND/MND), at a minimum, briefly discuss environmental impacts of the “No Project” alternative if this is not already included in the ND/MND.

FEDERAL CO-FUNDING SOURCES
Will the project potentially be co-funded by one or multiple other federal agencies? No – If no, continue to next section.

Yes – If yes, complete the following:

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 21 Environmental Package (Rev. 2/2024)

FEDERAL LANDS
Is any portion of the proposed project site located on federally managed land, such as United States Forest Service (USFS) or Bureau of Land Management (BLM) land? No – If no, continue to next section.

Yes – If yes, complete the following:
a) Indicate the type of federal land (e.g., USFS national forest, BLM Developed Recreation Area, etc.):

b) Identify the USFS Office, the BLM District, or other federal regional unit in which the project is located:

c) Provide the status of any use authorization or permit:

d) Provide the name of the associated federal agency contact person(s)/representative(s) assigned to the project:

Contact email(s):

Contact phone(s):
e) Attach the following documents to the Environmental Package:

1. A colored map identifying the project location with respect to the federal land

2. A copy of the appropriate authorization/permit for the use of federal land (e.g., USFS Special-Use Authorization, BLM Land Use Permit) if one has been obtained a) List the agency or agencies:
b) Explain the funding status:
c) Provide the name of the associated federal representative(s) with whom the water system has been in contact:

Contact email(s):

Contact phone(s):

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 22 Environmental Package (Rev. 2/2024)

ARCHAEOLOGICAL AND HISTORIC PRESERVATION ACT (AHPA)
Will the project cause the irreparable loss of or damage to a significant archaeological or historic resource or data through alteration of the terrain resulting from dam or reservoir construction (e.g., flooding, building of access roads, or construction of a reservoir)? No – If no, continue to next section.

Yes – If yes, complete the following:
a) Explain, or indicate where more information on this impact can be found [e.g., Historic Properties Identification Report (HPIR; see the National Historic Preservation Act below), CEQA document, etc.]:

CLEAN AIR ACT
Identify the project air basin:

Identify the local air district:

Is the project located in a nonattainment area, or an attainment area under a maintenance plan, for any criteria pollutant?
No – If no, continue to next section.

Yes – If yes, complete the following:
a) Identify the criteria pollutant(s) for which the project area is in nonattainment and the nonattainment rate(s) (i.e., marginal, moderate, serious, severe, or extreme), and/or identify the criteria pollutant(s) for which the project area is in attainment under a maintenance plan:
b) Complete the following table by filling in the estimated construction and operation emissions for each criteria pollutant:

Criteria Pollutant
Estimated
construction
emissions
(tons/year)
Estimated
operation
emissions
(tons/year)
Federal de minimis levels (tons/year)
Ozone (O3)
Oxides of Nitrogen
(NOX) and Volatile
Organic Compounds
(VOC)

Marginal/Moderate
NAA’s 100
Serious NAA’s 50
Severe NAA’s 25
Extreme NAA’s 10
Carbon Monoxide (CO) All maintenance areas 100

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 23 Environmental Package (Rev. 2/2024)
Nitrogen Dioxide (NO2) All NAA’s 100
Lead (Pb) All NAA’s 25
Particulate Matter less
than 2.5 microns in
diameter (PM2.5)

Moderate NAA’s 100
Serious NAA’s 70
Particulate Matter less
than 10 microns in
diameter (PM10)

Moderate NAA’s 100
Serious NAA’s 70
Sulfur Dioxide (SO2) All NAA’s 100
c) Attach the following documents to the Environmental Package:

1. Any documents utilized to support the estimated emissions above, or to compile the air quality data (e.g., air quality studies/models, CalEEMod report)

2. If any of the federal de minims levels are exceeded additional information may be required.

COASTAL ZONE MANAGEMENT ACT
Is any portion of the project site located within the coastal zone? No – If no, continue to next section.

Yes – If yes, complete the following:
a) Indicate the status of the coastal development permit or coastal exemption:

b) Describe the project location with respect to coastal areas, or indicate where this information can be found (e.g., CEQA document, biological report/assessment, etc.):
c) Attach the following documents to the Environmental Package:

1. A copy of the coastal development permit or coastal exemption (if available)

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 24 Environmental Package (Rev. 2/2024)

ENDANGERED SPECIES ACT (ESA)
Does the project involve any direct or indirect impacts, from construction or operation activities, that may affect federally listed threatened or endangered species, or their critical habitat, that are known or have potential to occur on the project site, in the surrounding area, or in the service area?
No – If no, complete the following:
a) Explain, or indicate where information supporting this determination can be found (e.g., biological report/assessment, CEQA document, etc.):

Yes – If yes, complete the following:
a) List the date(s) of any biological field surveys completed for the project:

b) Identify the federally listed species that could potentially be affected by the project:

c) Identify any proposed avoidance and conservation measures that will be implemented:

d) Indicate where more information about the impact(s) can be found (e.g., biological report/assessment, CEQA document, etc.):

e) If any consultations with state or federal agencies have been conducted for the project, summarize those consultation efforts:

f) Attach the following documents to the Environmental Package:

1. A project-level biological report/assessment

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 25 Environmental Package (Rev. 2/2024)

FARMLAND PROTECTION POLICY ACT
Is any portion of the project located on, or will the project impact prime, unique, or important farmland, or farmland under a Williamson Act Contract? No – If no, continue to next section.

Yes – If yes, complete the following:
a) If the project is located on or near prime, unique, or important farmland, or farmland under a Williamson Act Contract, but will avoid impacting the farmland (due to the scope of the project, implementation of avoidance measures, or for other reasons), please explain, or indicate where more information can be found (e.g., CEQA document, etc.):

b) Explain, and include information on the acreage that would be converted from farmland to other uses, or indicate where this information can be found (e.g., farmland conversion assessment, CEQA document, etc.):

c) If any portion of the project boundaries is under a Williamson Act Contract, specify the amount of acreage affected:

d) Attach the following documents to the Environmental Package:

1. Documents/assessments evaluating the conversion of prime/unique farmland and farmland of statewide/local importance to non-agricultural uses

2. Copies of any consultation(s) conducted with relevant agencies

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 26 Environmental Package (Rev. 2/2024)
FLOODPLAIN MANAGEMENT: EXECUTIVE ORDERS 11988, 12148, 13690, AND 14030
Is any portion of the project located within a 100-year floodplain as depicted on an official floodplain map or otherwise designated by the Federal Emergency Management Agency (FEMA)?
No – If no, continue to next section.

Yes – If yes, complete the following:
a) Identify any relevant consultations completed with other agencies:

b) Describe the floodplain and any proposed measures that will be implemented to minimize or avoid redirection of the flood flow by the project, or indicate where this information can be found (e.g., floodplains/hydrological assessment, CEQA document, etc.):

c) Attach the following documents to the Environmental Package:

1. Any reports (e.g., floodplains/hydrological assessment) completed for the project

2. An official floodplain map from the FEMA Flood Map Service Center that includes the project area

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 27 Environmental Package (Rev. 2/2024)

MAGNUSON-STEVENS FISHERY CONSERVATION AND MANAGEMENT ACT Does the project involve any direct or indirect impacts from construction or operational activities, or changes in water quality/quantity, that may impact Essential Fish Habitat (EFH)?
No – If no, continue to next section.

Yes – If yes, complete the following:
a) Describe how EFH could potentially be impacted by this project and any proposed avoidance and conservation measures, or indicate where this information can be found (e.g., biological report/assessment, EFH impact assessment/evaluation, CEQA document, etc.):

b) Describe any previous or ongoing consultations/coordination conducted with the NMFS for the project:

c) Attach the following documents to the Environmental Package:

1. EFH Impact Assessment (if available)

2. An official NMFS species list, obtained through the NMFS Essential Fish Habitat Mapper

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 28 Environmental Package (Rev. 2/2024)

NATIONAL HISTORIC PRESERVATION ACT (NHPA)
Identify Section 106 of the NHPA finding of effect contained in the cultural resources report:

No Historic Properties Affected
No Adverse Effect to Historic Properties
Adverse Effect to Historic Properties
Provide a brief explanation for the above identified determination, or indicate where this information can be found (e.g., HPIR or Cultural Report):

If relevant, please justify compliance with the NHPA:

Provide the following documents directly to the Division of Financial Assistance Cultural Resources Officer:

1. A Historic Properties Identification Report
a. Note: Please do not upload confidential documents to the FAAST system. Contact the Project Manager or the Environmental Review Staff for guidance regarding submission of confidential documents.
b. If the project is a type of activity that does not have the potential to cause effects to historic properties, a HPIR is not necessary. Contact the Review Staff to discuss this.

This decision is based on the type of activities, not on the presence or absence of historic properties.

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 29 Environmental Package (Rev. 2/2024)

PROTECTION OF WETLANDS
Will any portion of the project be located in or potentially affect a wetland? No – If no, continue to next section.

Yes – If yes, complete the following:
a) If the project is located in or near a wetland but will avoid impacting the wetland (due to the scope of the project, implementation of avoidance measures, or for other reasons), please explain, or indicate where more information can be found (e.g., wetland assessment/delineation report, biological report/assessment, CEQA document, etc.):

b) Indicate the status of any permits necessary for project construction (e.g., Clean Water Act Section 404 Permit, etc.):

c) Attach the following documents to the Environmental Package:

1. A wetland assessment/delineation report consistent with the United States Army Corps of Engineer (USACE) guidance describing the project’s potential impacts to wetlands and/or potential wetland areas

2. Documentation on the avoidance, minimization, and conservation measures that will be implemented to reduce such impacts

3. A copy of the Clean Water Act Section 401 Certification (if available)

4. A copy of the Clean Water Act Section 404 Permit (if available)

SAFE DRINKING WATER ACT/SOLE SOURCE AQUIFER PROTECTION
Is the project located in an area designated by the USEPA as a Sole Source Aquifer? No - If no, continue to next section.

Yes – If yes, complete the following:
a) Identify the Sole Source Aquifer:

b) Attach the following documents to the Environmental Package:

1. A completed Sole Source Aquifer Project Review Information document (contact the Division of Financial Assistance to request)

Financial Assistance Application Page 30 Environmental Package (Rev. 2/2024)

WILD AND SCENIC RIVERS ACT
Identify the watershed in which the project is located:

Will the project impact any listed wild and scenic rivers? No – If no, continue to next section.

Yes – If yes, complete the following:
a) Identify the wild and scenic river that will be impacted:
b) Explain how the project will impact the wild and scenic river, or indicate where this information can be found (e.g., biological report/assessment, CEQA document, etc.):
c) Attach the following documents to the Environmental Package:

1. A map of the impacted wild and scenic river and the relative project location

STATE OF CALIFORNIA FINANCIAL ASSISTANCE APPLICATION
STATE WATER RESOURCES CONTROL BOARD Drinking Water State Revolving Fund Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 31 Environmental Package (Rev. 2/2024)

FEDERAL ENVIRONMENTAL ATTACHMENTS
Complete the checklist indicating what federal documentation is being submitted attached to this Environmental Package. If there are questions about required attachments, please contact the Environmental Review Staff:
https://www.waterboards.ca.gov/water_issues/programs/grants_loans/environmental_requirements. html.

List of attachments:
5-Year Reaffirmation Memorandum: Signed by applicant’s authorized representative Federal Land: Map of federal lands
Federal Land: Federal land use authorization/permit
Clean Air Act: CalEEMod report or other air quality models/studies Coastal Zone Management Act: Coastal Development Permit or Coastal Exemption Endangered Species Act: Project-level biological report/assessment Farmland Protection Policy Act: Farmland Conversion Assessment Farmland Protection Policy Act: Copies of any consultation(s) with relevant agencies Floodplain Management: Floodplains/Hydrological Assessment or other report Floodplain Management: Official floodplain map
Magnuson-Stevens Fishery Conservation and Management Act: EFH Impact Assessment Magnuson-Stevens Fishery Conservation and Management Act: Official NMFS Species List National Historic Preservation Act: Historic Properties Identification Report Protection of Wetlands: Wetland Assessment/Delineation Report Protection of Wetlands: Documentation on avoidance and conservation measures Protection of Wetlands: Clean Water Act Section 401 Certification Protection of Wetlands: Clean Water Act Section 404 Permit Safe Drinking Water Act/Sole Source Aquifer Protection: Sole Source Aquifer Project Review Information
Wild and Scenic Rivers Act: Map of Wild and Scenic Rivers Watershed Other Federal Cross-Cutter Documentation:

Other Federal Cross-Cutter Documentation:

STATE WATER RESOURCES CONTROL BOARD
Division of Financial Assistance
P. O. Box 944212, Sacramento, CA 94244-2120
Financial Assistance Application Page 1 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
Financial Security Package Instructions
Applicant (Entity) Legal Name – Enter the full name of the entity that will be the legal signatory to a financing agreement.

Proposed Security – Enter the revenues and fund(s) you will use to repay the DWSRF financing.

Project Title – Enter the title of the project.

Contact Person and Phone – Enter the name and phone number of the day-to-day contact for the project.

This person should be able to answer financial questions about the project and application.

1. Financing Amount Requested
Estimate the project costs to be funded with State Water Board DWSRF funds. This amount should match the Amount of Assistance Requested in Section 1 of the General Information Package.

2. Term Requested
Indicate the financing term you are requesting: 20-year, 30-year or 40-year (if eligible).

3. Other Project Funding Sources
Describe how the total project will be financed.

ü Enter the name(s) and type(s) of all funding sources. ü Enter the amount of funds you expect to receive from each source. ü Check the appropriate box to indicate whether the other sources of financing have been applied for, approved by the funding agency, or received by the applicant. ü Submit copies of other funding sources commitment or debt documents.

Example: DWSRF financing $1,000,000
USDA grant $ 500,000
Applicant Agency portion $ 250,000

4. Current Year Median Household Income: Determination by Division Enter the estimated Median Household Income (MHI) for the proposed project service area, using the most recent income survey. If an income survey is not available, MHI estimates may be found at the Census Bureau website at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml#none. Enter “Median Household Income in the Past 12 Months” and the municipality name into the Quick Search box. If you cannot locate data for your community, you may contact the Division at [email protected] for additional assistance. MHI determinations are considered preliminary and will be finalized once the complete application is reviewed.

Financial Assistance Application Page 2 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund

5. Current Year Estimated Population Served
Enter the estimated population of the water system service area.

6. Active Service Connections
If active water service connections are currently and directly served by the water system, enter the following for each applicable connection type:
ü Number of active water service connections that are currently and directly served by the water system
ü Projected average monthly service charge that will be in place after the proposed project is completed
ü Average monthly billing for the last 12 months
Rate increase effective date for projected monthly service charges – Enter the estimated date that the projected monthly service charges will go into effect (if unknown, assume one year after construction completion).

7. Projected Annual Operations and Maintenance Costs
Enter the estimated annual costs to operate and fully maintain the proposed project after it is complete.

Operations and maintenance costs include staff salaries, chemicals, utilities, warranties, routine repair and replacement, laboratory services, billing and collection and life-cycle costs. The consulting engineer should have included these costs in the Engineering Report. (Attachment T1).

8. Discussion of Material Events, Material Obligation Conditions, and Any Debt Limit Identify any current, prior, or pending material events such as bankruptcy, defaults, litigation, grand jury findings, unscheduled draws on reserve funds, substitution of insurers or their failure to perform, unscheduled draws on credit enhancements, actions taken in anticipation of filing Chapter 9, rating changes, relevant conditions in material obligations, and any local debt limit.

9. Water Rate Study
Indicate whether a water rate study has ever been performed on your water system as well as the date of the study and subsequent findings. If you respond yes, please submit a complete copy of the Water Rate Study.

ATTACHMENTS
F1- Audited Financial Statements: Provide COMPLETE audited financial statements for the most-recent three fiscal years. If the applicant is not required to complete audited financial statements, the applicant should provide the three most-recent years of Federal and State tax returns.

Identify any restricted funds and the reason for the restrictions as well as all sources of security to be pledged.

If using real property, provide at least two appraisals of the value, how the value was determined, and whether the property is currently pledged as security on any other debt.

Financial Assistance Application Page 3 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
F2 - Budget Projections (Revenue/Expense): Provide projections for at least the next two fiscal years.

Sample of Projections
Operating Revenue
Projections
2020/21
Projections
2021/22
Water Sales $2,552,866 $2,680,509
Utility Billing Charges $830,000 $871,500
Water Discharge Fee $15,000 $15,750
Connection Fees $475,000 $498,750
Other Income $25,000 $26,250
Other Non-Operating Revenue
Interest Income $7,000 $7,350
Property Tax $1,200,300 $1,260,315
Other Misc. Income $2,000 $2,100
Total Revenue $5,107,166 $5,362,524
Operating Expenses
Salaries $1,500,000 $1,575,000
Water Purchases $1,200,000 $1,260,000
Operating Supplies $500,000 $525,000
Repair and Maintenance $78,000 $81,900
Professional Fees $30,000 $31,500
Legal $20,000 $21,000
Lease/Rents $950,000 $997,500
Utility Billing Service $300,000 $315,000
Total Operating Expenses $4,578,000 $4,806,900
Net Revenue $529,166 $555,624
Existing Debt Service $93,000 $93,000
Total Net Revenue after Debt Service $436,166 $462,624
F3 – Tax Questionnaire: To be completed and submitted with an application for all loan projects (except for privately-owned entities). The Tax Questionnaire provides basic information about project costs, accounting, and who will own and operate the project. The applicant’s response to the Tax Questionnaire and Reimbursement Resolution (below) are reviewed by the State Water Board’s DWSRF tax attorney to determine whether the applicant is eligible to receive funds from tax-exempt revenue bond sales. This item is not required if the applicant is applying for 100% percent grant/principal forgiveness funding.

F4 – Reimbursement Resolution: All loan applicants that are publicly-owned entities are required to submit an adopted Reimbursement Resolution for review by the DWSRF tax attorney. The language may not vary from the language provided in the template. The Reimbursement Resolution should be a stand-alone resolution. This item is not required if the applicant is applying for 100% percent grant/principal forgiveness funding.

Financial Assistance Application Page 4 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
F5a – Authorizing Resolution/Ordinance (for use by publicly owned entities): This resolution or ordinance designates the Authorized Representative(s) for the project, who will have the authority to sign and submit the DWSRF application materials, certify compliance with applicable state and federal laws, execute the financial assistance agreement and amendments, and certify disbursement requests. v To minimize the potential for problems, use the exact language in the template resolution. v Enter the title of the Authorized Representative, NOT a person’s name. v Do not modify the words financing or financial assistance to other terms such as “loan”, “grant”, or “principal forgiveness”. Use of these terms will create legal complications; the terms “financing” and “financial assistance” are broad enough to be applicable to all of the above.

F5b – Corporate Resolution to Apply, Borrow and Grant Security (for use by private applicants): This resolution designates the Authorized Representative(s) for the project, who will have the authority to sign and submit the DWSRF application materials, certify compliance with applicable state and federal laws, execute the financial assistance agreement and amendments, certify disbursement requests, grant security interest, and authorize State Water Resources Control Board to perform any acts necessary to perfect security. v To minimize the potential for problems, use the exact language in the template resolution. v Enter the title of the Authorized Representative, NOT a person’s name.

F5c –Other Entity Type: If you are a limited partnership, general partnership, trust, or sole proprietor please contact the Division of Financial Assistance for guidance on the documentation required for designating an Authorized Representative.

F6 – Rate Adoption Resolution, Copy of Rates, and Public Notice of Proposition 218 Meeting: Attach a copy of the most recent board resolution, ordinance, or similar document which approved the rates currently in place, a copy of the rates, and a copy of the Proposition 218 pubic meeting notice.

F7 – Schedule of Related Debt and Debt Document Copies: Submit a schedule of all material debt secured by the Pledged Revenues and Fund(s), along with a copy of each relevant debt document (e.g., loans, private placements, bond indentures, installment sale agreements, etc.). If there are any pending debts, provide draft or estimated information. This schedule will be an exhibit to the DWSRF financing agreement and will rank related debt according to priority in relation to the proposed DWSRF debt (senior, parity, or subordinate tier). If the applicant has no other debt (except other DWSRF debt), the Authorized Representative must provide a letter stating this. In most cases, the DWSRF debt will be on parity with related debt.

F8- Debt Management Policy: Applicant needs to submit a copy of their debt management policy. Guidance on Complying with SB 1029 Release Date: December 28, 2016- http://www.treasurer.ca.gov/cdiac/sb1029/guidance.pdf (not applicable if 100% grant/principal forgiveness funding).

F9 – New Special Tax, Assessment District, or service charge projections: If applicable, provide budget projections based on proposed taxes, fees, charges or assessments (No template exists). Label the projections as Attachment F9.

F10 – Relevant Service, Management, Operating, or Joint Powers Agreements: If applicable, provide a copy of any relevant, service, management, operating or joint powers agreements and any amendments (No template exists). Label the agreement as Attachment F10.

F11 - District Certification of Interim Report (For School Districts Only): School Districts should provide a complete copy of their most-recent District Certification of Interim Report, including the signed Criteria and Standards Review Section.

Financial Assistance Application Page 5 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund

FINANCIAL SECURITY PACKAGE
(CONSTRUCTION)
Applicant (Entity) Legal Name:

Pledged Revenues And Fund(s) For The Project:

Project Title:

Contact Person: Phone:

1. Amount of Assistance Requested: $

2. Term Requested: 20-Year 30-Year 40-Year (If Eligible)

3. Other Project Funding Sources
Name and Type of
Funding Sources Amount Applied Approved Received
$
$
$

4. Current Year Median Household Income: $
5a. Current Year Estimated Population Served:
5b. Current Year Estimated Number of Residences:
5c. Current Year Estimated Number of Permanently Occupied Residences:
(Only required if applying for grant funding/principal forgiveness)

6. Active Service Connections Not Applicable
Service Connection Type Number of Service Connections
Average Monthly Billing
(Last 12 months)
Per Connection
Residential $
Commercial $
Industrial $
Other $
TOTAL $
Rate increase effective date for projected monthly service charges:

7. Projected Annual Operations and Maintenance Costs, Including amortized replacement costs (upon completion):
$

Financial Assistance Application Page 6 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund

8. Discussion of Material Events, Material Obligation Conditions, and Any Debt Limit Identify any current prior material events such as bankruptcy, defaults, litigation, grand jury findings, unscheduled draws on reserve funds, substitution of insurers or their failure to perform, unscheduled draws on credit enhancements, actions taken in anticipation of filing Chapter 9, rating changes, relevant conditions in material obligations, and any local debt limit.

9. Rate Study
Has a rate study been conducted for your system? Yes No If yes, please submit a complete copy of the Rate Study.

10. Debt Management Policy
Please provide a copy of your Debt Management Policy (If Applicable).

ATTACHMENTS (Check the box next to each item attached to your application.) F1 – AUDITED FINANCIAL STATEMENTS OR TAX RETURNS (3 Years) F2 – BUDGET PROJECTIONS (REVENUE/EXPENSE) (2 years – or more if needed) (See Sample in Application Instructions)
F3 – TAX QUESTIONNAIRE
F4 – REIMBURSEMENT RESOLUTION
F5a – AUTHORIZING RESOLUTION
F5b – CORPORATE RESOLUTION
F5c – OTHER ENTITY TYPE
F6 – RATE ADOPTION RESOLUTION, COPY OF RATES, AND PUBLIC NOTICE OF PROPOSITION 218 MEETING
F7 – SCHEDULE OF ALL MATERIAL DEBT OR NO DEBT LETTER
(See Application Instructions)
F8 – DEBT MANAGEMENT POLICY (If Applicable)
F9 – NEW SPECIAL TAX, ASSESSMENT DISTRICT, OR SERVICE CHARGE PROJECTIONS (If Applicable)
F10 – RELEVANT SERVICE, MANAGEMENT, OPERATING, OR JOINT POWERS AGREEMENTS (If Applicable)
F11 – SCHOOL DISTRICT CERTIFICATION OF INTERIM REPORT (If Applicable)

Financial Assistance Application
(Rev. 3/2022)

Drinking Water State Revolving Fund
Attachment F3

STATE WATER RESOURCES CONTROL BOARD

STATE REVOLVING FUND PROGRAM
TAX QUESTIONNAIRE (Version April 2015)

LEGAL NAME OF APPLICANT
State Use Only:

Project No. DATE/TIME REC’D BY
SWRCB
Instructions: Answer all and provide all information and documents requested. Begin typing in the shaded area and the space will enlarge to accommodate the information that is typed. In lieu of typing in the shaded areas for any question, a separate page may be attached to this Tax Questionnaire or an electronic file in Word format may be attached.

Certain Definitions: As used in this Tax Questionnaire, "Project" means the facilities and/or capital improvements that you described in the Financial Assistance Application submitted to the State Water Board and constitutes those costs that will be funded by the State Water Board under the Financing Agreement (a template Financing Agreement can be found on the State Water Board’s website), “Governmental Entity” means a state, city, county, town, public school district, other special district or joint powers authority, and "Non-Governmental Entity" means any person, partnership, corporation or other organization that is not organized as a state, city, county, town, public school district, other special district or joint powers authority. The federal government constitutes a NonGovernmental Entity. A Section 501(c)(3) organization constitutes a Non-Governmental Entity.

1. Briefly describe the Project, its functions and its principal components.

2. Indicate by principal components your current estimates of the costs of the Project, as follows:
a. Construction costs.................................................................................................. $ b. Equipment costs..................................................................................................... $ c. Land Purchase........................................................................................................ $ d. Rehabilitation or renovation of facilities................................................................ $ e. Site preparation costs............................................................................................. $ f. Architectural/engineering, design and planning costs............................................ $ g. Engineering and administrative costs during construction..................................... $ h. Surveys.................................................................................................................. $ i. Legal fees............................................................................................................... $ j. Financing costs...................................................................................................... $ k. Commitment fees and deposits.............................................................................. $ l. Other construction costs (please specify)............................................................... $ m. Other planning/design costs (please specify)......................................................... $

3. Will any portion of the financing provided under the Financing Agreement be used to refinance other debt(s) (e.g., including any bonds, notes, leases or commercial paper) relating to the Project? Yes No Not Applicable

4. If you answered “yes” to Question #3, please state the amount of financing provided under the Financing Agreement that is expected to be used for refinancing purposes.
$

Financial Assistance Application
(Rev. 3/2022)

Drinking Water State Revolving Fund

5. If you answered “yes” to Question #3, please specify the date(s) on which the financing provided under the Financing Agreement will be used to redeem other debt(s) relating to the Project.

6. If you answered “yes” to Question #3, please provide the following information:
a. Name of the existing indebtedness to be refinanced:
b. Issue date of the existing indebtedness:
c. Par amount of the existing indebtedness:
d. Purpose(s) of the existing indebtedness:
e. Whether the existing indebtedness is immediately prepayable:
f. Whether the interest on the existing indebtedness is federally taxable or tax-exempt:

7. If you answered “yes” to Question #3, are any proceeds of the other debt(s) relating to the Project still unspent? Yes No Not Applicable
If yes, please identify the amounts and the funds or accounts in which such proceeds are on deposit.

8. If you answered “yes” to Question #3, was the other debt(s) to be refinanced with the financing provided under the Financing Agreement used to refinance other prior debt(s) relating to the Project? Yes No Not Applicable
If yes, please provide the name of the original indebtedness, the issue date of the original indebtedness, the par amount of the original indebtedness, the purpose(s) of the original indebtedness, and whether the interest on the original indebtedness was federally taxable or tax-exempt.

9. Will any portion of the financing provided under the Financing Agreement be used for new financing of the Project? Yes No Not Applicable

10. If you answered “yes” to Question #9, please provide the dates of expected commencement and completion of constructionof the Project.

Expected Commencement Date of Project: ............................

Expected Completion Date of Project:....................................

11. If you answered “yes” to Question #9, please state the amount of the financing provided under the Financing Agreement that is expected to be used for new financing purposes. If you answered “no” to Question #9, skip to Question #18 below. $

Financial Assistance Application
(Rev. 3/2022)

Drinking Water State Revolving Fund

12. If you answered “yes” to Question #9, please state the amount of Project costs to be newly financed under the Financing Agreement that are expected to be paid within the following periods of time:
· Please respond to this question using the expected initiation date of construction. · Project costs to be spent within 6 months.........................................................................$ · Project costs to be spent within 12 months (cumulative)..................................................$ · Project costs to be spent within 18 months (cumulative)..................................................$ · Project costs to be spent within 24 months (cumulative)..................................................$ · Project costs to be spent within 30 months (cumulative)..................................................$ · Project costs to be spent within 36 months (cumulative)..................................................$ · Project costs to be spent beyond 36 months (cumulative).................................................$

13. If you answered “yes” to Question #9, have you paid any costs of the Project prior to the date hereof? Yes No Not Applicable
For each Project cost that has been previously paid, please provide an itemization of the following:
a. Amount of the payment ....................................................................................................... b. Purpose of the payment ................................................................................................ c. Date of the Payment ..................................................................................................... d. Source of payment of such cost (e.g., revenue, federal or state grants, other financing, internal loan ........................................................................................

14. If you answered "yes" to Question #13, have you at any time adopted a resolution or other official action (e.g., a socalled “reimbursement resolution”) relating to your intent to finance the Project with financial assistance from the State Water Board or other indebtedness?
Yes No Not Applicable
If yes, please identify the date of such resolution or other document and attach a copy.

15. If you answered “yes” to Question #9, will any portion of the financing provided under the Financing Agreement be used to pay administrative or engineering expenses directly relating to the construction of the Project? Yes No Not Applicable
If yes, please state the amount expected to be so used and provide details as to its calculation (e.g., based on actual costs or a percentage of construction).

16. If you answered “yes” to Question #15, will any portion of the administrative or engineering expenses directly relating to the construction of the Project be incurred by the staff of the Applicant? Yes No Not Applicable
If yes, please state the amount expected to be so used and provide details as to its calculation (e.g., based on actual costs or a percentage of construction).

Financial Assistance Application
(Rev. 3/2022)

Drinking Water State Revolving Fund

17. If you answered "yes" to Question #16, will the administrative or engineering expenses directly relating to the construction of the Project be tracked by an accounting system, such as a cost accounting system, that will allow them to be differentiated from other charges for other work done by the applicant’s staff? Yes No Not Applicable
If yes, please specify how charges will be tracked.

18. Does any Non-Governmental Entity own, or do you anticipate any Non-Governmental Entity owning, any portion of the Project at any time during the term of the financing?
Yes No Not Applicable
If yes, identify the Non-Governmental Entity and provide all available details with respect to its ownership interest.

19. Does any Non-Governmental Entity lease, or do you anticipate any Non-Governmental Entity leasing, any portion of the Project at any time during the term of the financing?
Yes No Not Applicable
If yes, identify the Non-Governmental Entity and provide all available details with respect to its lease interest.

20. Have you entered, or do you anticipate entering, into any inter-municipal contract or agreement(s) with any GovernmentalEntity with respect to the Project (or any portion of the Project) during the term of the financing? Yes No Not Applicable
If yes, please describe the purpose of each such agreement, and attach a copy of any existing or contemplated agreement.

21. Have you entered, or do you anticipate entering, into any contract or agreement with any Non-Governmental Entity contracting to operate, manage or provide any exclusive services with respect to the Project (or any portion of the Project) during the term of the financing?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity and explain the arrangement. If an operations, management or exclusive services contract currently exists, please attach a copy. Contracts that relate solely to services that are merely incidental to the primary use of the Project need not be listed. Examples of incidental services are contracts for janitorial services, office equipment repairs or billing services. If you are uncertain as to whether the contract is incidental or not, please describe the contract and the services provided thereunder.2

22. Does the Project provide, or do you anticipate the Project providing, water or wastewater services to any NonGovernmental Entity other than on the basis of standard rates and charges which are generally applicable and uniformly applied and are adjusted from time to time by the Applicant? Yes No Not Applicable
If there are or will be any non-standard rates and charges, describe the rate structure, focusing on any special rate agreements or charges for specific entities. An example of a non-standard rate is an industrial user paying a flat fee in a system where the other users pay a rate based on usage.
w

Financial Assistance Application
(Rev. 3/2022)

Drinking Water State Revolving Fund

23. Does any Non-Governmental Entity have, or do you anticipate any Non-Governmental Entity having, special priority rights or other preferential rights to use the Project or the services of the Project pursuant to any contractual or other arrangement?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity, and describe the special priority or preferential right(s).

24. Are the functions and services of the entire Project available, and do you expect the functions and services of the entire Project will be available for use by the general public on a first-come, first-served basis? Yes No Not Applicable
If no, please explain and describe the portion of the Project that is not, or will not, be available for use by the general public.

For example, municipal water and wastewater systems used for residential, commercial, governmental and business purposes are available for use by the general public; a specialized pollution control facility immediately adjacent to a private business that is the sole user of the facility is not available for use by the general public.

25. Have you entered, or do you anticipate entering, into a “take” or “take-or-pay” contract with any Non-Governmental Entity for use of any portion of the Project or the services of the Project? Yes No Not Applicable
If yes, please identify the Non-Governmental Entity, and describe the arrangement therewith. If a take or a take-or-pay contract currently exists, please attach a copy.

26. Will any Non-Governmental Entity guarantee or otherwise be directly obligated to repay the financial assistance providedunder the Financing Agreement?
Yes No Not Applicable
If yes, please identify the Non-Governmental Entity, and describe the guarantee arrangement therewith.

27. Have you received, or do you expect to receive, any grant or other form of assistance for financing of any portion of the Project from the State of California, the federal government or any other entity or person? Yes No Not Applicable
If yes, please explain.
28 Will any portion of the financing projected under the Financing Agreement be used as a substitute for other funds which were otherwise to be used as a source of financing and which have been used or will be used to acquire, directly or indirectly, other investment property?
Yes No Not Applicable
If yes, please explain.

Financial Assistance Application
(Rev. 3/2022)

Drinking Water State Revolving Fund

APPLICANT ACKNOWLEDGEMENT AND SIGNATURE
I hereby certify that I am an authorized representative of the Applicant, and that I am authorized by the Applicant to execute this Tax Questionnaire. I am charged with the responsibility to perform such acts as are necessary and proper for the financing, construction, acquisition and/or improvement of the Project, and am acting for and on behalf of the Applicant in executing this Tax Questionnaire. I certify that I am familiar with the Project and that all information contained herein is true, correct and complete to the best of my knowledge. I am not aware of any facts or circumstances that would cause me to question the accuracy or reasonableness of any information contained in these responses or attached documentation. I understand that the foregoing information and attached documentation will be relied upon by the State Water Board and their counsel, in providing financing with respect to the Project.

AUTHORIZED REPRESENTATIVE

SIGNATURE

PRINT NAME AND TITLE DATE

Financial Assistance Application Page 13 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
Attachment F4

REIMBURSEMENT RESOLUTION
WHEREAS, the __________________________________ (the "Agency") desires to finance the costs of (Agency Name)
constructing and/or reconstructing certain public facilities and improvements relating to its water system, including certain treatment facilities, pipelines and other infrastructure (the "Project"); and WHEREAS, the Agency intends to finance the construction and/or reconstruction of the Project or portions of the Project with moneys ("Project Funds") provided by the State of California, acting by and through the State Water Resources Control Board (State Water Board); and
WHEREAS, the State Water Board may fund the Project Funds with proceeds from the sale of obligations the interest upon which is excluded from gross income for federal income tax purposes (the "Obligations"), and WHEREAS, prior to either the issuance of the Obligations or the approval by the State Water Board of the Project Funds the Agency desires to incur certain capital expenditures (the "Expenditures") with respect to the Project from available moneys of the Agency; and
WHEREAS, the Agency has determined that those moneys to be advanced on and after the date hereof to pay the Expenditures are available only for a temporary period and it is necessary to reimburse the Agency for the Expenditures from the proceeds of the Obligations.

NOW, THEREFORE, THE AGENCY DOES HEREBY RESOLVE, ORDER AND DETERMINE AS FOLLOWS:

SECTION 1. The Agency hereby states its intention and reasonably expects to reimburse Expenditures paid prior to the issuance of the Obligations or the approval by the State Water Board of the Project Funds.

SECTION 2. The reasonably expected maximum principal amount of the Project Funds is $_____________. {Remove this Note when completing the Resolution: Please include the maximum reasonable project amount. Your SRF financing agreement will not exceed this amount under any circumstances.} SECTION 3. This resolution is being adopted no later than 60 days after the date on which the Agency will expend moneys for the construction portion of the Project costs to be reimbursed with Project Funds.

SECTION 4. Each Agency expenditure will be of a type properly chargeable to a capital account under general federal income tax principles.

SECTION 5. To the best of our knowledge, this Agency is not aware of the previous adoption of official intents by the Agency that have been made as a matter of course for the purpose of reimbursing expenditures and for which tax-exempt obligations have not been issued.

SECTION 6. This resolution is adopted as official intent of the Agency in order to comply with Treasury Regulation §1.150-2 and any other regulations of the Internal Revenue Service relating to the qualification for reimbursement of Project costs.

SECTION 7. All the recitals in this Resolution are true and correct and this Agency so finds, determines and represents.

AYES: _______
NOES: _______
ABSENT: _______

CERTIFICATION
I do hereby certify that the foregoing is a full, true, and correct copy of a resolution duly and regularly adopted at a meeting of the _____________________________________________ held on __________________. (Governing Board of the Agency) (Date)
(Name, Signature, and Seal of the Clerk or Authorized Record Keeper of the Governing Board of the Agency)

Financial Assistance Application Page 14 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
Attachment F5a

AUTHORIZING RESOLUTION/ORDINANCE
RESOLUTION NO: _____________________
WHEREAS _____________________________________________________________________________ (insert appropriate findings)
RESOLVED BY THE _______________________________________________________________OF THE (insert name of Governing Board of the Entity)
________________________________________________________________ (the “Entity”), AS FOLLOWS:
(insert Entity name)
The ____________________________________________ (the “Authorized Representative”) or designee is (insert Title of Authorized Representative)
hereby authorized and directed to sign and file, for and on behalf of the Entity, a Financial Assistance Application for a financing agreement from the State Water Resources Control Board for the planning, design, and construction of ___________________________________________________________ (the “Project”). (insert Project Name)
This Authorized Representative, or his/her designee, is designated to provide the assurances, certifications, and commitments required for the financial assistance application, including executing a financial assistance agreement from the State Water Resources Control Board and any amendments or changes thereto.

The Authorized Representative, or his/her designee, is designated to represent the Entity in carrying out the Entity’s responsibilities under the financing agreement, including certifying disbursement requests on behalf of the Entity and compliance with applicable state and federal laws.

CERTIFICATION
I do hereby certify that the foregoing is a full, true, and correct copy of a resolution duly and regularly adopted at a meeting of the ___________________________________________________________ held (insert name of Governing Board of the Entity)
on ______________________.
(Date)
(Name, Signature, and Seal of the Clerk or Authorized Record Keeper of the Governing Board of the Agency)

Financial Assistance Application Page 15 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
Attachment F5b
SAMPLE

CORPORATE RESOLUTION

TO APPLY, BORROW AND TO GRANT SECURITY
I, __________________________, do hereby certify that I am the duly elected and qualified Secretary and the keeper of the records and corporate seal of ____________________________, a corporation organized and existing under the laws of the State of California (the "Corporation"), and that the following is a true and correct copy of certain resolutions duly adopted by the Board of Directors thereof, in accordance with law and the by-laws of the Corporation, and that such resolutions are now in full force and effect, unamended, unaltered and unrepealed:

WHEREAS, the Corporation seeks financing from the State Water Resources Control Board under the Drinking Water State Revolving Fund (“DWSRF”) for a project commonly known as __________________________________________________________ (“Project”); WHEREAS, the Board of Directors adopted a Project budget; and WHEREAS, prior to the State Water Resources Control Board executing a financing agreement, the Board of Directors is required to establish a dedicated source of revenue to repay the DWSRF loan and authorizing an officer to execute all financing agreements, amendments, certifications, and claims for reimbursement.

NOW, THEREFORE, BE IT RESOLVED AND ORDERED, that the
__________________________________________ (“the Authorized Representative”) is (insert title of Authorized Representative)
hereby authorized to sign and file, for and on behalf of the Corporation, an application for financial assistance from the State Water Board for the planning, design, and/or construction of the Project; BE IT FURTHER RESOLVED AND ORDERED, that the Authorized Representative is designated to provide the assurances, certifications, and commitments required for the financial assistance application, including executing a financial assistance agreement from the State Water Resources Control Board and any amendments or changes thereto; BE IT FURTHER RESOLVED AND ORDERED, that the Authorized Representative is hereby authorized to incur Indebtedness not to exceed $_____________________ pursuant to the DWSRF financing agreement (The term "Indebtedness" as used herein means all debts, obligations and liabilities, currently existing or now or hereafter made, incurred or created in connection with the financing);
BE IT FURTHER RESOLVED AND ORDERED, that the Authorized Representative is hereby authorized to grant security interests in, pledge, assign, transfer, endorse, mortgage or otherwise hypothecate to the State Water Resources Control Board, and execute security or pledge agreements, financial statements and other security interest perfection documentation, mortgages and deeds of trust on, and give trust receipts for, any or all property or assets of the Corporation as may be agreed upon by the Authorized Representative, or his/her designee, as collateral security for any or all of the Indebtedness, and to grant and execute renewals, extensions or modifications thereof, and to authorize the State Water Resources Control Board to perform any act necessary to perfect security, including but not limited to filing a Uniform Commercial Code (UCC-1) lien with the Secretary of State; BE IT FURTHER RESOLVED AND ORDERED, that the Authorized Representative is authorized to represent the Corporation in carrying out the Corporation’s responsibilities under

Financial Assistance Application Page 16 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
the financing agreement, including certifying disbursement requests on behalf of the Corporation and compliance with applicable state and federal laws;
BE IT FURTHER RESOLVED, that the Secretary or any other officer of this Corporation is authorized to certify to the State Water Resources Control Board a copy of these resolutions and the name and signature of the Authorized Representative hereby authorized to act hereunder, and the State Water Resources Control Board is hereby authorized to rely upon such certificate until formally advised by a like certificate of any change therein, and is hereby authorized to rely on any such additional certificates; and BE IT FURTHER RESOLVED AND ORDERED, the authority granted hereunder shall be deemed retroactive. All acts authorized hereunder and performed prior to the date of this Resolution are hereby ratified and affirmed. The State Water Resources Control Board is authorized to rely upon this Resolution until written notice to the contrary, executed by each of the undersigned, is received by the State Water Resources Control Board. The State Water Resources Control Board shall be entitled to act in reliance upon the matters contained herein, notwithstanding anything to the contrary contained in the formation documents of the______________________________________________ or in any other document. (Applicant entity’s legal name)
I FURTHER CERTIFY THAT the following person has been appointed or elected and is now acting as officer or employee of the Corporation in the capacity set beside his name:
(Print Name) (Date) (Signature)
IN WITNESS WHEREOF, I have subscribed my name as Secretary as of ___________________, 20___. (Date)
____________________________
Secretary
___________________________, a California corporation

Financial Assistance Application Page 17 of 17 Financial Security Package (Construction) (Rev. 12/2019) Drinking Water State Revolving Fund
Attachment F7

SCHEDULE OF SYSTEM OBLIGATIONS
Except for the following and the Obligation evidenced by this Agreement, the Recipient certifies that it has no outstanding System Obligations and that it is in compliance with all applicable additional debt provisions of the following:

The following related debts are senior to the proposed DWSRF financing:

Name of Lender
and Title of Debt
or Loan Number
Debt Security or
Source of
Revenue
Debt Service
Coverage
Requirement
Original
Debt
Amount
Current
Balance
Payment
Amount
Interest
Rate
Debt Term &
Maturity Date
$ $ $ /
$ $ $ /
$ $ $ /
The following related debts are on parity to the proposed Financing Agreement:

Name of Lender
and Title of Debt
or Loan Number
Debt Security or
Source of
Revenue
Debt Service
Coverage
Requirement
Original
Debt
Amount
Current
Balance
Payment
Amount
Interest
Rate
Debt Term &
Maturity Date
$ $ $ /
$ $ $ /
$ $ $ /
$ $ $ /
$ $ $ /
The following related debts are subordinate to the proposed Financing Agreement:

Name of Lender
and Title of Debt
or Loan Number
Debt Security or
Source of
Revenue
Debt Service
Coverage
Requirement
Original
Debt
Amount
Current
Balance
Payment
Amount
Interest
Rate
Debt Term &
Maturity Date
$ $ $ /
$ $ $ /
$ $ $ /
$ $ $ /
$ $ $ /
Attach copies of the debt documents associated with the above debts.

CITY COUNCIL

AGENDA REPORT

MEETING
DATE:

November 12, 2024
TO: Mayor and City Council
FROM: Greg Thompson, Deputy City Manager/Community Development Director

PREPARED
BY:

John Seymour, City Engineer
SUBJECT: Adoption of the Local Roadway Safety Plan as prepared by the Merced County Association of Governments (Deputy City Manager/ Community Development Director Thompson)

RECOMMENDED COUNCIL ACTION
Adoption of Resolution No. 3506-24 adopting the Local Roadway Safety Plan for the City of Atwater prepared by the Merced County Association of Governments.

I. BACKGROUND/ANALYSIS:

The United States Department of Transportation (US DOT) incorporated the Safe System Approach as part of its most recent National Roadway Safety Strategy (NRSS), adopted in January 2022. This NRSS is the first national commitment to the goal of zero fatalities on America’s roadways, and names the Safe System Approach as the way to accomplish that goal. Federal transportation officials have since unveiled a number of policies and programs geared towards the application and implementation of the Safe System Approach at the state and local levels.

The Safe System Roadway Design Hierarchy, created by the Federal Highway Administration (FHWA) in 2024, provides guidance in contextualizing and assessing infrastructure-based countermeasures and strategies on their alignment with the principles of the Safe System Approach. The Hierarchy classifies countermeasures into four tiers, from most to least aligned with Safe System principles. These tiers are:

1. Removing severe conflicts, which can act to eliminate high-risk conditions that involve users with different speeds or moving in different directions sharing space. This tier can include countermeasures that remove potential points of conflicts (for example, removing conflicting turning movements), and those that separate vulnerable users from vehicles in space (for example, protecting people biking through a separated bike lane).

2. Reducing vehicle speeds, which reduces the kinetic energy present within systems and thereby reduces the severity of crashes that do occur. As driver behavior,

CITY COUNCIL
Mike Nelson, Mayor
Danny Ambriz Tyler Button
John Cale Brian Raymond

Agenda Report - Adoption of the Local Roadway Safety Plan as prepared by the Merced County Association of Governments (Deputy City Manager/ Community Development Director Thompson)

especially when it comes to speed, is highly influenced by roadway features, countermeasures that reduce prevailing speeds can include lane narrowing and features that channelize vehicle traffic such as median islands.

3. Managing conflicts in time, which covers instances (such as intersections) where space needs to be shared between different users, but where they can be separated in time. An example is the Leading Pedestrian Interval, which allows people walking to have a ”head start” interval at a signalized intersection before conflicting vehicle traffic enters the crosswalk.

4. Increasing attentiveness and awareness, which involves alerting users to conflicts and potential risks, can involve such countermeasures as intersection daylighting and warning signage.

The Local Roadway Safety Plan commits the City of Atwater to the goal of eliminating serious injuries and fatalities on its roadway network. It also identifies proven countermeasures that can be implemented through roadway design.

II. FISCAL IMPACTS:

None by this action.

III. LEGAL REVIEW:

This item has been reviewed by the City Attorney's office.

IV. EXISTING POLICY:

The adoption of the LRSP plan is consistent with the circulation element of the City's adopted General Plan to enhance pedestrian and roadway safety.

V. ALTERNATIVES:

N/A
VI. INTERDEPARTMENTAL COORDINATION:

This item has been routed to all relevant departments for review.

VII. PUBLIC PARTICIPATION:

The public will have an opportunity to comment on this item prior to City Council approval.

VIII. ENVIRONMENTAL REVIEW:

This item is exempt under the provisions of the California Environmental Quality Control Act.

IX. STEPS FOLLOWING APPROVAL:

Agenda Report - Adoption of the Local Roadway Safety Plan as prepared by the Merced County Association of Governments (Deputy City Manager/ Community Development Director Thompson)

Following adoption by city council, council shall direct the City manager or his designee to sign the resolution adopting the City of Atwater Local Roadway Safety Plan.

Submitted by:

Greg Thompson, Deputy City Manager/Community Development Director Approved by:

Chris Hoem, City Manager
Attachments:

1. RSO XXXX-24 LRSP Adoption 11.7.24

2. Vol2_Atwater

CITY COUNCIL
OF THE

CITY OF ATWATER

RESOLUTION NO. XXXX-24

A RESOLUTION OF THE ATWATER CITY

COUNCIL APPROVING THE LOCAL ROADWAY

SAFETY PLAN FOR THE CITY OF ATWATER

PREPARED BY THE MERCED COUNTY

ASSOCIATION OF GOVERNMENTS
WHEREAS, at the Merced County Association of Governments Board of Governors Meeting on October 24, 2024, the Merced County Association of Governments adopted a multijurisdictional Local Roadway Safety Plan; and,
WHEREAS, this action consists of adopting Volume 2 “City of Atwater” portion of the Multijurisdictional Local Roadway Safety Plan ; and,
WHEREAS, the proposed adoption of the roadway safety plan would not have a detrimental effect on the health, safety, and welfare of the neighborhood nor have any adverse effect on the community; and,
NOW THEREFORE BE IT RESOLVED, that the City Council of the City of Atwater does hereby adopt the Local Roadway Safety Plan prepared by MCAG for the City of Atwater.

The foregoing resolution is hereby adopted this 12th day of November 2024.

AYES:

NOES:

ABSENT:

Resolution No. XXXX-24 Page 2
APPROVED:
__________________________________

MIKE NELSON, MAYOR
ATTEST:
______________________________
KORY J. BILLINGS, CITY CLERK

1 City of Atwater

Chapter 2 of Caltrans’ Local Roadway Safety
Manual (LRSM) instructs safety practitioners
to “consider a wide range of data sources to
get an overall picture of the safety needs.” To
this end, this Local Roadway Safety Plan will
be data-driven and synthesize findings from
collison records alongside input from key
stakeholders, a technical advisory group, and
staff.

Collision records on roadways in Atwater from
2015 to 2022 were investigated to describe
historic collision trends and identify high-risk
locations. This information acts as a primary
resource for this Plan, providing the underlying
data to support key analyses.

Collision Analysis
The data-driven process for the creation of
this Plan includes:
• Examination of Collision Trends
Review of collision statistics to evaluate
when, where, and why collisions occur and
who is involved.
• Development of a High-Injury Network
Identification of roadways where most
injury collisions are concentrated for
targeted intervention.
• Development of Collision Profiles of
Emphasis
Identification of the most prevalent
collision types and contexts based on a
combination of collision factors.
• Creation of a Countermeasure Toolbox
Identification of effective, nationally
proven countermeasures applicable to
different collision profiles.
• Identification of Priority Project Locations
Identification of locations suitable for
project implementation based on collision
density and community verification.

The following section will present findings
from the first of these stages of data analysis,
identifying collision patterns and trends.

4 0
10 20
30 40
50 60
70 80
90 100
110
2015 2016 2017 2018 2019 2020 2021 2022
Modal Breakdown
0 10
20 30
40 50
60 70
80 90
100
110
2015 2016 2017 2018 2019 2020 2021 2022
0 2
4 6
8 10
12 14
16 2015 2016 2017 2018 2019 2020 2021 2022
Modal Breakdowns over Time
Vehicle-Only Collisions
Bicycle Collisions
Pedestrian Collisions
Figure 1.2
KSI Collisions by Year,
2015-2022
Vehicle-Only Collisions
Bicycle Collisions
Pedestrian Collisions
Figure 1.1
Injury Collisions by Year,
2015-2022
A Note on the Data Source
This analysis utilizes data on injury
collisions from 2015 through 2022
available through the Transportation
Injury Mapping System (TIMS) as of
August 2023. TIMS reports injury
collisions from the Statewide Integrated
Traffic Records System (SWITRS), but
excludes collisions that cause property
damage only (PDO) and no injuries.

Geographically, the data includes all
collisions that occur within the City of
Atwater. The data excludes collisions
on Route 99, as it is a controlled-access
roadway (i.e. freeway), but includes
collisions on all other roadways,
including State highways and other
Caltrans-maintained roadways as well as
privately-maintained roadways.

While collision databases like TIMS
remain the best source of collision data,
they have been found to have certain
reporting biases, including:
• Collisions involving people walking,
on bicycles, or on motorcycles
are less likely to be reported than
collisions with people driving
• Property damage only collisions are
less likely to be reported compared
to more severe collisions
• Younger victims are less likely to
report collisions
• Alcohol-involved collisions may be
underreported
Race, income, immigration status, and
English proficiency may also impact
reporting, but there is limited research
on these factors.

5 Figure 1.3
Collision
Mode Share
by Severity,
2015-2022
Vehicle-Only Collisions
Bicycle Collisions
Pedestrian Collisions
Modal Breakdowns by Percent
84%
6%
10%
Vehicle Bike Ped
69%
11%
20%
Vehicle Bike Ped
Injury Collisions
by Percent
69%
11%
20%
Vehicle Bike Ped
KSI Collisions
Collisions by Year and by Mode
The table below provides a summary
of the number of collisions in Atwater
by mode and severity within the
dataset, which includes all collisions
that resulted in injury or fatality. From
2015 to 2022, there were a total of 621
injury collisions, of which 55 were KSI
collisions: collisions where someone was
killed or severely injured.

Collision Summary Total KSI
Total 621 55
Bicycle 37 6
Pedestrian 61 11
Figures 1.1 and 1.2 show the temporal
trends of collisions in Atwater. As shown,
the annual number of injury collisions in
Atwater has fluctuated through the study
period, but peaks in 2021, as restrictions
associated with the COVID-19 pandemic
began to lift. The number of KSI collisions
per year over the study period has also
fluctuated, but also with the largest
increase occurring in 2021. This is in
line with national trends in 2020 and
2021, during and after the initial wave
of the pandemic, where the number of
collisions, especially KSI collisions, have
increased despite travel restrictions and
decreases in traffic volume.

People walking or biking are particularly
vulnerable in the event of a collision,
as they lack the protection afforded to
them by being inside a motor vehicle.

As a result, collisions involving people
walking or biking are more likely to
result in injury and fatality. As shown in
Figure 1.3, people walking and biking are
involved in 16% of all injury collisions,
but 31% of KSI collisions.

6 Collisions by Collision Type
Figure 1.4 illustrates the share of collisions in
the study period that fall into each collision
type. As shown, the most common collision
types across all injury collisions in Atwater are
broadside collisions at 33%, rear-end collisions
at 28%, and head-on collisions at 10%.

Taking a closer look at KSI collisions shows a
different breakdown. Broadside collisions are
also the most common type of KSI collisions, at
24%, followed by vehicle-pedestrian collisions
at 20%, and head-on collisions at 16%.

This illustrates the disproportionate impact
in severity that collision type can play. For
example, while rear-ends account for a large
share of overall collisions, they are generally
less likely to result in fatalities and severe
injuries. By contrast, broadsides and head-ons
are more represented amongst KSI collisions,
as these typically involve more kinetic energy
and result in more serious collision outcomes.

This also further illustrates the significantly
disproportionate impact people walking
face in the event of a collision, as vehiclepedestrian collisions are significantly overrepresented in the KSI collision record.

Collisions by Primary Collision Factor
Figure 1.5 illustrates the share of collisions in
the study period that are classified under each
Primary Collision Factor (PCF). PCFs are cited
by the responding officer and are based on
that person’s judgment of what contributed to
the collision. It is important to note that PCFs
do not include contextual information about
the design aspects of the collision location
that could have been primary or secondary
contributors to a collision.

In Atwater, the most common PCFs are Vehicle
Right of Way Violation at 28% of collisions,
Unsafe Speed at 25%, and Improper Turning at
10%.

Taking a closer look at KSI collisions shows
a different PCF breakdown percentage.

The most common PCFs for KSI collisions
are Vehicle Right of Way Violation at 24%,
Improper Turning at 18%, and Unsafe Speeds
at 15%.

7 Collision Type
10%
9%
28%
33%
8%
1%
8%
3%
16%
5%
4%
24%
11%
7%
20%
13%
0%
5%
10%
15%
20%
25%
30%
35%
Head-On Sideswipe Broadside Hit Object Overturned Vehicle- Other Pedestrian
Rear-End
PCF
28%
25%
10%
7%
5% 4% 4%
7%
11%
24%
15%
18%
7% 7%
4%
5%
11%
9%
0%
5%
10%
15%
20%
25%
30%
Unsafe
Speed
Improper
Turning
Vehicle Right Other
of Way
Violation
DUI Wrong
Side of
Road
Signals
and Signs
Pedestrian- Related* Unsafe Lane
Change
Figure 1.4
Share of Injury Collisions by Collision Type, 2015-2022 Figure 1.5
Share of Injury Collisions by Primary Collision Factor (PCF), 2015-2022 * Note on Pedestrian PCF Categories
The “Pedestrian-Related” category shown here combines two PCF categories: “Pedestrian Violation” and “Pedestrian Right of Way Violation.” The former indicates that the pedestrian violated a rule of the road, such as crossing outside of a crosswalk, where the latter indicates the driver of a vehicle violated the pedestrian’s right of way. The Pedestrian Violation category may be overrepresented due to a lack of clear information related to collision circumstances, and the increased likelihood that the pedestrian party may be unable to provide their side of the incident at the time of the collision. For this reason, we have elected to not show the distinction in these tallies, and instead show all pedestrian-related collisions in one single category.

Injury Collisions
KSI Collisions
Injury Collisions
KSI Collisions

8 Collisions by Lighting Conditions
Figure 1.6 illustrates the share of collisions
in the study period that occur at night*.

As shown, nighttime collisions are
overrepresented among KSI collisions. While
27% of all injury collisions occurred at night
where streetlights were present and a further
2% occurred where streetlights were not
present or present but not functioning, those
percentages jump to 32% and 13% for KSI
collisions, respectively.

Collisions that occur during nighttime also
disproportionately affect people walking,
with almost two-thirds of all pedestrian KSI
collisions occurring at night.

The concern around lighting is especially
relevant given Atwater’s small-town context
and rural surroundings. There continue to be
locations without functional street lighting
in the City, and collisions at those locations
are disproportionately represented in the KSI
collision record. Furthermore, even where
streetlights were present, the quality of the
lighting can vary widely. Factors that may
contribute to the quality of streetlights include
lights being insufficiently bright, placed too
widely apart, or poor quality of lighting for
people walking on the sidewalk, as streetlights
are often designed primarily for vehicles in
travel lanes.

Driving Under the Influence (DUI)
Figure 1.7 illustrates the share of collisions of
various types in the study period that involved
at least one party driving under the influence
(DUI). Drugs or alcohol increase the likelihood
of increased crash severity. As shown, the
number of DUI collisions are overrepresented
amongst KSI collisions. While 9% of all injury
collisions involve drugs or alcohol in Atwater,
23% of KSI collisions do.

These percentages reflect the portion of
collisions involving one or more parties
determined to be under the influence of drugs
or alcohol. Driving under the influence may
not always be listed as the primary collision
factor even if a driver is found to be under the
influence.
* Nighttime collisions are defined as those collisions
whose lighting information is not reported as "daylight".

9 Lighting
27%
a Nighttime Daytime
13%
32%
a Nighttime DaytimeN
All Collisions KSI Collisions Ped
Injury Collisions
Lighting
e
13%
32%
a Nighttime Daytime
9%
55%
Nighttime Daytime
KSI Collisions Pedestrian KSIs
KSI Collisions
e
9%
55%
Nighttime Daytime
Pedestrian KSIs
Pedestrian
KSI Collisions
DUI
91%
9%
Vehicle Bike
Figure 1.7
DUI Collisions,
2015-2022
DUI Collisions
Other Collisions
DUI
91%
9%
Vehicle Bike
84%
16%
Vehicle Bike
Injury Collisions
KSI Collisions
Figure 1.6
Nighttime
Collisions,
2015-2022
Daytime
Collisions
Nighttime Collisions,
Streetlights Working
Nighttime Collisions, Streetlights
Not Present or Not Working

10 Collisions by Pedestrian Location
Figure 1.8 illustrates for pedestrian-involved
collisions the location of the pedestrian(s)
at the time of collision. The most common
location for pedestrians at the time of collisions
is crossing the street, whether at a marked
crosswalk (43%) or not (21%). This is followed
by walking in or along the shoulder of the
roadway, at 13%, and collisions with the
pedestrian(s) not on the roadway at all, at 11%.

For pedestrian KSI collisions, crossing at and not
at a crosswalk were equally common at 27%,
followed by walking in or along the shoulder of
the roadway and not in road at 18% each.

This data illustrates the importance of both the
presence and appropriate design of sidewalks,
crosswalks and other similar pedestrian
facilities that help reduce the risk of people
being struck by separating them from moving
vehicles.

Furthermore, the high number of collisions
occurring with people walking in the roadway
or shoulder or crossing not at crosswalks shows
that there are pedestrian desire lines currently
unserved by sidewalks and existing crosswalks.

This points to the need for improving the
coverage of pedestrian infrastructure and
closing gaps.

Collisions by Day of Week
Figure 1.9 illustrates the share of collisions in
the study period by day of week. As shown,
while injury collisions are overall fairly evenly
distributed across the seven days of the week,
KSI collisions are heavily concentrated on
the weekends, with 44% of KSIs occurring on
Saturday and Sunday.

11 Pedestrian Location
Crossing at
Intersection
Crosswalk
Crossing at
Midblock
Crosswalk
In Road or
Shoulder
Crossing Not in Road Other
Not at
Crosswalk
43%
7%
21%
13%
11%
5%
27%
0%
27%
18% 18%
9%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Figure 1.8
Share of Pedestrian-Involved Injury Collisions by
Pedestrian Location at Time of Collision, 2015-2022
Injury Collisions
KSI Collisions
Figure 1.9
Share of Injury Collisions by Day of Week, 2015-2022
15% 16% 15%
12%
16% 15%
11% 11% 11%
13% 13%
9%
24%
20%
0%
5%
10%
15%
20%
25%
Mon Tue Wed Thu Fri Sat Sun
Day of WeekInjury Collisions
KSI Collisions

12 High Injury Network
From the collision data, a High Injury Network
was developed to identify the roadways
in Atwater with the highest levels of injury
collisions, as shown on Figure 1.10.

The High Injury Network consists of just 9% of
the roadway network in Atwater, but is the site
of the majority of injury collisions. Of the 621
collisions that occurred during the study period,
409, or 66%, were located along the network.
55 of these study period collisions were KSIs,
of which 34, or 62%, were located along the
network.
99 99
99 Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
Figure 1.10
High Injury Network
City of Atwater
N

13

14 Equity Considerations
Both Merced County and the larger Central
Valley region have historically been subject
to underinvestment and marginalization. As
a result, most of the region, including most
areas within the six cities covered by this
Plan, are identified as disadvantaged by the
various criteria used by the state and Federal
governments.

The Federal government has introduced
a number of tools used to identify
disadvantaged communities. In particular,
two of these, the Climate and Economic
Justice Screening Tool (CEJST) and the
Equitable Transportation Communities (ETC)
Explorer, are of particular note, as they see
extensive use by the Federal Department
of Transportation (DOT) in delineating
disadvantaged areas, especially as part of
grant funding opportunities.

Climate and Economic Justice
Screening Tool (CEJST)
The Climate and Economic Justice Screening
Tool (CEJST) is maintained by the Federal
Council on Environmental Quality and used
by many Federal programs as a means of
identifying disadvantaged communities.

Census tracts are screened based on a variety
of factors, including climate, energy, health,
housing, transportation, legacy pollution,
waste, and workforce development.

Equitable Transportation
Communities (ETC) Explorer
The US Department of Transportation
(DOT) created Equitable Transportation
Communities (ETC) Explorer as part of its
Justice40 initiative to complement the
CEJST by providing additional insight into
transportation factors specifically. The ETC
Explorer is meant to capture the cumulative
burden of underinvestment in transportation
in a community.

Figure 1.11 shows areas in Atwater identified
as disadvantaged under these two criterion.

As shown, almost the entirety of the Atwater,
as well as all the unincorporated areas to the
north of the city, is identified as disadvantaged
by both metrics. The far southeastern corner
of the city and the far southern fringes of
the city south of SR 99 are the only areas not
identified by either metric. The vast majority
of collisions in Atwater occur within these
disadvantaged areas, including 95% of all
injury collisions and 93% of all KSI collisions.

15 99
99 99
Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
Figure 1.11
CEJST and ETC Explorer Results
City of Atwater
N
identified as disadvantaged by CEJST
identified as disadvantaged by ETC Explorer
identified as disadvantaged by both

2 City of Atwater

Collision Profiles
Through a systemic analysis of collision
records, collision profiles were identified
to represent the most significant patterns
behind injury collisions � and especially KSI
collisions � in the region. Seven such profiles,
identified with the letters “A” through “G”
were identified across the region, with each
one applicable to one, several, or all of the
communities covered by this LRSP.

Atwater is covered by six of these profiles:

A. Driving Under The Influence
B. Dark Conditions
C. Side Street Stop-Controlled Intersections
D. Excessive Roadway and Lane
Widths Leading To Speeding
E. Driveway Clusters on Arterials
F. Non-Standard Intersection Geometry
The following pages contain cutsheets that
present each collision profile, along with the
following information:
• Description and associated information
about each profile
• Number of collisions associated, including
number of KSI collisions among those
(note that profiles are not mutually
exclusive; collisions can fall under multiple
profiles, and totals will exceed 100%)
• A map of collision locations
Engineering countermeasures that can
potentially address these collisions are also
presented with each profile. The full suite of
engineering countermeasures can be found in
Chapter 3 of Volume I.

18 Driving under the influence is a significant
contributor to injury collisions, especially and
disproportionately to collisions that cause
someone to be killed or severely injured (KSI).

DUIs are clustered around the weekend and
around nighttime. Across the region, 54% of
all DUI collisions occurred on Friday, Saturday,
and Sunday, and 65% occurred in the dark.

However, it is important to note that a
substantial number of DUI collisions occurred
outside these time periods as well.

Non-engineering interventions will need to
be the primary means of addressing these
challenges, but may be supplemented with
the listed engineering countermeasures that
aim to make roadway designs more forgiving
in general.

Driving Under The Influence KSIs
17 (31%)
4 (4%)
9 (10%)
Injury
89 (14%)
Potential Supplemental Engineering Countermeasures
Separated
Bikeway
Add
Sidewalk
Rumble
Strips
Improved
Pavement
Friction
Safety
Edge
Guardrail
Roundabout
Intersection
Reconstruction
and Tightening
Raised
Median
Delineators,
Reflectors,
and/or Object
Markers
Speed Limit
Reduction
Remove
Obstructions
For Sightlines
Speed
Sensitive Rest
in Red Signal
Curve Advance
Warning Sign
Chevron Signs
on Horizontal
Curves
LEDEnhanced
Sign
Speed
Feedback
Sign
Upgrade
Striping
Red
Light
Cameras
Signal
Coordination/
Green Wave

PROFILE A

19 99
99 99
Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
N
Figure 1.12
Profile A Collisions
City of Atwater
KSI collisions
Other injury
collisions

20 A substantial number of collisions are
occurring in the nighttime across the region.

Based on the percentage of nighttime
collisions, meaningful progress toward
reducing collisions will require improvements
that enhance nighttime visibility such as
lighting, retroreflective signage, and sightline
improvements.

Dark Conditions KSIs
25 (45%)
6 (3%)
21 (12%)
Injury
179
(25%)
Potential Engineering Countermeasures
Separated
Bikeway
Add
Sidewalk
Rumble
Strips
Safety
Edge
Guardrail
Intersection
Reconstruction
and Tightening
Raised
Median
Delineators,
Reflectors,
and/or Object
Markers
Speed Limit
Reduction
Remove
Obstructions
For Sightlines
High-Visibility
Crosswalk
Pedestrian
Hybrid
Beacon
Leading
Pedestrian
Interval
Curve Advance
Warning Sign
Chevron Signs
on Horizontal
Curves
Upgrade
Striping
Raised
Crosswalk
Intersection
Lighting
Segment
Lighting
Rectangular
Rapid
Flashing
Beacon
Retroreflective
Tape on Signals
Advance
Stop Bar
Advance
Yield
Markings

PROFILE B

21 99
99 99
Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
N
Figure 1.13
Profile B Collisions
City of Atwater
KSI collisions
Other injury
collisions

22 Similar to permissive left-turn operations,
the question of who has right-of-way can be
confusing for drivers in side street stop-controlled
intersections as well as accurately judging and
using a gap in traffic can also be challenging. Also
similar to permissive left-turn operations, high
traffic volumes, high speeds, and limited visibility
due to roadway width on the major crossing
contribute to risk at these locations.

Side street stop-controlled intersections often are
accompanied by either an uncontrolled crossing
of the major roadway, or no crossing altogether,
and a long series of side street stop-controlled
intersections will likely create long stretches of
the major roadway without protected crossings
for people walking, biking or otherwise needing
to cross the major street.

Atwater saw a total of 203 collisions at
side-street stop-controlled intersections,
accounting for a quarter of all injury crashes
within the city. Of the collisions, 18 were
KSIs and 33 involved bicycles or pedestrians.

The top primary collision factors (PCFs) were
vehicle right-of-way violations, accounting
for a third of all such collisions, followed by
speeding at 30%.

Side Street Stop-Controlled
Intersections
KSIs
18 (33%)
13 (6%)
20 (10%)
Injury
203
(33%)

PROFILE C

23 99
99 99
Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
N
Figure 1.13
Profile C Collisions
City of Atwater
KSI collisions
Other injury
collisions

24 Advance
Stop Bar
Upgrade
Intersection
Pavement
Markings
Yield To
Pedestrians
Sign
Flashing
Beacon as
Advance
Warning
Upgrade
Striping
Bus Stop
Relocation/
Enhancements
Signal
Coordination/
Green Wave
Potential Engineering Countermeasures
Green
Conflict
Striping
Separated
Bikeway
All-Way
Stop
Control
Centerline
Hardening
Signal
Partial
Closure/
Diverter
Raised
Intersection
Curb
Extensions
Speed Limit
Reduction
Add
Sidewalk
Upgrade
Uncontrolled
Pedestrian
Crossings
Restrict Left Turns
with Directional
Median Openings
Lane
Narrowing
Straighten
Crosswalk
Extend Bike
Lane to
Intersection
Refuge
Island
Road
Diet
Remove
Obstructions
For Sightlines
Roundabout
Intersection
Lighting
High-Visibility
Crosswalk
Splitter
Island
Intersection
Reconstruction
and Tightening
Raised
Median
Raised
Crosswalk
Delineators,
Reflectors,
and/or Object
Markers
Pedestrian
Hybrid
Beacon
Remove
Crossing
Prohibition
Restripe
Crosswalk
Leading
Pedestrian
Interval
Upgrade
Curb
Ramp
Prohibit
Left Turn
Widen
Sidewalk
Advance
Yield
Markings
Rectangular
Rapid
Flashing
Beacon
Striping
Through
Intersection
Speed
Feedback
Sign
TimeBased Turn
Restriction
Median
Guardrail
Side Street Stop-Controlled
Intersections
KSIs
18 (33%)
13 (6%)
20 (10%)
Injury
203
(33%)

PROFILE C

25 The region’s agricultural heritage has resulted
in many roadways that are designed to be
wide enough to accommodate larger vehicles,
such as trucks and farm equipment. However,
many of these design features are no longer
necessary as many areas become more
residential or retail-oriented in character.

Many roadways around the region feature
more vehicle travel lanes than their demand
necessitates, which can influence driver
behavior towards higher speeds. Moreover,
many of the region’s roadways feature travel
lanes that are wider (often significantly so)
than the recommended maximum of 11ft,
which is another major contributor to speeding
behavior. High speeds on roadways not only
poses risks for vehicles, but also make them less
comfortable to walk or ride along and to cross
for bicyclists and pedestrians.

Speeding is a major contributor to injury
collisions in the region. It is cited as the primary
collision factor for nearly a quarter of all injury
collisions in the study area, as well as 14% of all
KSI collisions. It is also important to note that
speeding can also be a factor in other collisions
where it is not cited as the primary collision
factor, and that the number of speeding-related
collisions in the region is likely higher.

Excessive Roadway and Lane
Widths Leading To Speeding
Potential Engineering Countermeasures
Bike Lane
Green
Conflict
Striping
Curve Advance
Warning Sign
Curb
Extensions
Speed Limit
Reduction
Add
Sidewalk
Extend Bike
Lane to
Intersection
Remove
Obstructions
For Sightlines
Lane
Narrowing
Separated
Bikeway
Speed Hump
or Speed Table
Speed
Feedback
Sign
Raised
Intersection
Refuge
Island
Road
Diet
Raised
Crosswalk
Delineators,
Reflectors,
and/or Object
Markers
High-Visibility
Crosswalk
Pedestrian
Hybrid
Beacon
Remove
Crossing
Prohibition
Widen
Sidewalk
Rectangular
Rapid
Flashing
Beacon
Improved
Pavement
Friction
Safety
Edge
Restripe
Crosswalk
Extend
Pedestrian
Crossing Time
Extend Yellow
and All Red
Time
Shorten
Cycle
Length
Advance
Stop Bar
Advance
Yield
Markings
Speed Legends
on Pavement at
Neighborhood
Entries
Partial
Closure/
Diverter
Neighborhood
Traffic Circle
Back-In
Angled
Parking
Improved
Pavement
Friction
Intersection
Reconstruction
and Tightening
Signal
Coordination/
Green Wave
KSIs
15%
Injury
25%

PROFILE D

26 Atwater features many instances of the land
use typology of suburban, parking-fronted
shopping centers along high-speed, multilane arterials that feature frequent driveway ingresses and egresses. Frequent interactions
between fast-moving arterial traffic with
slow traffic turning from or to driveways is a
significant risk factor, with left turns to or from
such driveways being particularly conflictprone. Higher densities of these driveways add additional complexity and risk. These
contexts are particularly problematic for people
walking and biking, who must also interact with
frequent driveway crossings while traveling on
sidewalks or bike facilities in such areas. These
areas are also likely to feature higher volumes
of walking and biking, as they are often
significant destinations featuring essential retail
and services.

In Atwater, this typology is found along Bellevue
Road from Third Street and Elmer Wood
Elementary School to Constitution Drive and
Osborn Park. A total of 37 collisions occurred at
driveway clusters along this short, three-quarter
mile stretch, accounting for 6% of all citywide
collisions. This included 8 collisions involving
bikes and pedestrians, and 3 KSI collisions. The
predominant PCFs were speeding, right-of-way
violations, and improper turning, accounting for
more than two-thirds of these collisions.

The engineering countermeasures below
should be supplemented with land use
improvements, such as enhancing pedestrian
access through parking lots, changes to
land use that feature more street-fronted
development.

Driveway Clusters
on Arterials
KSIs
3 (6%)
2 (5%)
6 (16%)
Injury
37 (6%)
Potential Engineering Countermeasures
Extend Bike
Lane to
Intersection
Green
Conflict
Striping
Separated
Bikeway
Restrict Left Turns
with Directional
Median Openings
Partial
Closure/
Diverter
Road
Diet
Access
Management/
Close Driveway
Curb
Extensions
Speed Limit
Reduction
Add
Sidewalk
Lane
Narrowing
Bike Lane
Remove
Obstructions
For Sightlines
Segment
Lighting
Upgrade
Curb
Ramp
Prohibit
Left Turn
Widen
Sidewalk
Advance
Yield
Markings
SharedUse Path
Co-Locate
Bus Stops and
Pedestrian
Crossings
Striping
Through
Intersection
Raised
Median
Refuge
Island
Splitter
Island
Upgrade
Intersection
Pavement
Markings
Upgrade
Striping
Yield To
Pedestrians
Sign
Raised
Crosswalk
Improved
Pavement
Friction
Access
Management/
Close Driveway
Median
Guardrail

PROFILE E

27 99
99 99
Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
N
N
Figure 1.14
Profile E Collisions
City of Atwater
KSI collisions
Other injury
collisions

28 Atwater features a number of intersections
with more than four legs and/or roadways
intersecting at non-right angles, which
contributes to limited visibility, especially for
turning traffic. Moreover, these intersections
tend to be large by virtue of their geometry,
which lengthens crossing distances and makes
them especially difficult to navigate for people
biking and walking. They also can feature slip
lanes for certain turning movements that allow
free flow turning traffic to proceed at higher
speeds, which poses additional risk for people
walking and biking as well conflicting traffic.

In Atwater, these include the five-way
intersection of Bellevue Road, Shafter Road,
and First Street; the intersection of Shafter
Road and Atwater Boulevard; the intersection
of First Street and Linden Street; and a series
of intersections along Winton Drive near
Downtown. Despite being a small subset of the
road network, these intersections combined
saw 85 collisions – more than 13% of the
citywide total, of which 8 were KSI collisions
and 13 involved bicycles or pedestrians.

Speeding and vehicle right-of-way violations
were the top PCF categories, accounting for
nearly two-thirds of collisions.

Non-Standard
Intersection Geometry
KSIs
8 (15%)
6 (7%)
7 (8%)
Injury
85 (14%)

PROFILE F

29 99
99 99
Bellevue Rd Bellevue Rd Shaffer Rd Winton Way
1st St
Juniper Ave
Hospital Ave
Shaffer Rd
Atwater Blvd
Juniper Ave
Buhach Rd
Applegate Rd
Giannini Rd
Fleming Rd
Green Sands Ave
Olive Ave
N
N
Figure 1.15
Profile F Collisions
City of Atwater
KSI collisions
Other injury
collisions

30 Potential Engineering Countermeasures
Bicycle Signal/
Exclusive
Bike Phase
Bike
Box
Bike
Detection
Bike Lane
Green
Conflict
Striping
Extend
Green Time
For Bikes
Centerline
Hardening
Curb
Extensions
Speed Limit
Reduction
Add
Sidewalk
Extend Bike
Lane to
Intersection
Protected
Intersection
Bicycle
Crossing (Solid
Green Paint)
Intersection
Reconstruction
and Tightening
Remove
Obstructions
For Sightlines
Intersection
Lighting
Lane
Narrowing
Roundabout
Signal
Separated
Bikeway
Two-Stage
Turn Queue
Bike Box
All-Way
Stop
Control
Floating Transit
Island or Bus
Boarding Island
Raised
Intersection
Straighten
Crosswalk
Refuge
Island
Road
Diet
Raised
Crosswalk
Delineators,
Reflectors,
and/or Object
Markers
Upgrade
Uncontrolled
Pedestrian
Crossings
High-Visibility
Crosswalk
Pedestrian
Countdown
Timer
Pedestrian
Hybrid
Beacon
Leading
Pedestrian
Interval
Remove
Crossing
Prohibition
Restripe
Crosswalk
Upgrade
Curb
Ramp
Widen
Sidewalk
Rectangular
Rapid
Flashing
Beacon
Retroreflective
Tape on Signals
Speed
Sensitive Rest
in Red Signal
Supplemental
Signal Heads
Advanced
Dilemma Zone
Detection
Extend
Pedestrian
Crossing Time
Extend Yellow
and All Red
Time
Prohibit
Left Turn
Prohibit
Right-Turnon-Red
Separate
Right-Turn
Phasing
Shorten
Cycle
Length
Upgrade
Signal
Head
Protected
Left Turns
Prohibit
Turns During
Pedestrian
Phase
Advance
Stop Bar
Advance
Yield
Markings
Pedestrian
Scramble
Striping
Through
Intersection
Upgrade
Intersection
Pavement
Markings
Upgrade
Striping
Yield To
Pedestrians
Sign
Wayfinding
Close or
Reconfigure
Approaches
Signal
Coordination/
Green Wave
Non-Standard
Intersection Geometry
KSIs
8 (15%)
6 (7%)
7 (8%)
Injury
85 (14%)

PROFILE F

31

CITY COUNCIL

AGENDA REPORT

MEETING
DATE:

November 12, 2024
TO: Mayor and City Council
FROM: Greg Thompson, Deputy City Manager/Community Development Director

PREPARED
BY:

John Seymour, City Engineer
SUBJECT: Approve a Design Services Agreement between the City of Atwater and Mark Thomas for the Preparation of the Project Study Report for the Buhach Road Widening Project (Deputy City Manager/Community Development Director Thompson)

RECOMMENDED COUNCIL ACTION
Adoption of Resolution No. 3507-24 approving a Design Services Agreement, in a form approved by the City Attorney, to Mark Thomas Company of Fresno, CA in an amount not to exceed $173,352 for the preparation of the Project Study Report for the Buhach Road Widening Project; and to authorize and direct the City Manager to execute the Agreement on behalf of the City.

I. BACKGROUND/ANALYSIS:

MCAG hosted an Eastside Regional Technical working group meeting on August 23, 2023, regarding the applications for funding. On October, 4, 2023, the Eastside regional projects committee met to vote on project programming and recommendations to the governing board. The Merced County Association of Governments governing board met on November 16, 2023 approving funding for the Buhach Widening at Livingston Canal Project.

On January 18, 2024 MCAG formally approved the 2023 Measure V implementation Plan for the Buhach widening at Livinigston Canal Project. MCAG staff developed a Draft Master Measure V Regional Project Funding Agreement and refined it with input from member agencies. The City of Atwater approved the Master Measure V Regional project Funding Agreement at its regular meeting of the City Council on December 10, 2018. The Measure V Regional Project Funding Agreement (project specific) includes an estimated project completion date, requires the initiation of consultant contracts and/or start of construction within six (6) months from the execution date of the agreement, and requires MCAG to receive and process invoices for member agency reimbursement within thirty (30) days.

CITY COUNCIL
Mike Nelson, Mayor
Danny Ambriz Tyler Button
John Cale Brian Raymond

Agenda Report - Approve a Design Services Agreement between the City of Atwater and Mark Thomas for the Preparation of the Project Study Report for the Buhach Road Widening Project (Deputy City Manager/Community Development Director Thompson) Page 2

On August 6, 2024 the city of Atwater began advertising for the Request for Proposals for the PSR-PDS on the Buhach Road Widening Project. Proposals were received on September 5, 2024. Having reviewed and scored the proposals received, staff recommends the City Council select Mark Thomas for award, and approve the Design Services Agreement.

II. FISCAL IMPACTS:

The total fiscal impact of this contract is $173,352.00. Sufficient funding is available via the Measure V regional sales tax. The city has been authorized up to $200,000 for the preparation of the PSR-PDS document.

III. LEGAL REVIEW:

The Final contract shall be in a form as approved by the City Attorney.

IV. EXISTING POLICY:

This item is consistent with the Circulation element of the city's currently adopted General Plan.

V. ALTERNATIVES:

N/A
VI. INTERDEPARTMENTAL COORDINATION:

This has been routed to all relevant departments.

VII. PUBLIC PARTICIPATION:

The public will have an opportunity to comment on this item prior to City Council Action.

VIII. ENVIRONMENTAL REVIEW:

This project/item is exempt under the provisions of the California Environmental Quality Control Act.

IX. STEPS FOLLOWING APPROVAL:

Following approval, City Council will direct the City Manager or his designee to execute the design services agreement with Mark Thomas and Company.

Submitted by:

Greg Thompson, Deputy City Manager/Community Development Director Approved by:

Agenda Report - Approve a Design Services Agreement between the City of Atwater and Mark Thomas for the Preparation of the Project Study Report for the Buhach Road Widening Project (Deputy City Manager/Community Development Director Thompson) Page 3

Chris Hoem, City Manager
Attachments:

1. Resolution Buhach PSR-PDS (1)

2. Template Design Services Agreement (2024) - Task Order-c1

CITY COUNCIL
OF THE

CITY OF ATWATER
RESOLUTION NO. XXXX-24

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF

ATWATER APPROVING A DESIGN SERVICES AGREEMENT

FOR THE PREPARATION OF THE PSR-PDS FOR THE

BUHACH ROAD WIDENING PROJECT WITH MARK THOMAS
& COMPANY OF FRESNO, CA.

WHEREAS, Measure V is a county-wide, half-cent Transportation Sales Tax Measure approved by Merced County voters in November 2016, under which MCAG is authorized to administer the proceeds; and
WHEREAS, The Merced County Association of Governments and the City of Atwater entered into a Measure V Regional funding agreement for the preparation of the PSRPDS for the Buhach Road Widening Project; and WHEREAS, This item is not a "Project" as defined under Section 21065 of the Public Resources Code in that it would not directly or foreseeably indirectly significantly impact the physical environment; therefore this item is not subject to analysis under the California Environmental Quality Act (CEQA); and
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Atwater does hereby approve a Design Services Agreement, in a form approved by the City Attorney, to Mark Thomas Company of Fresno, CA in an amount not to exceed $173,352 for the preparation of the Project Study Report for the Buhach Road Widening Project.

Resolution No. XXXX-24 Page 2
The foregoing resolution is hereby adopted this 12th day of November 2024.

AYES:

NOES:

ABSENT:

APPROVED:

________________________________

MIKE NELSON, MAYOR
ATTEST:
_______________________________
KORY J. BILLINGS, CITY CLERK

1 [***MODEL - REMOVE THIS TITLE WHEN USED***]
[***FOR DESIGN SERVICES ONLY]
****PLEASE NOTE: THIS DESIGN SERVICES AGREEMENT MAY ONLY BE USED TO CONTRACT FOR DESIGN SERVICES. FOR ALL OTHER PROFESSIONAL SERVICES, PLEASE USE THE MODEL PROFESSIONAL SERVICES AGREEMENT****]

CITY OF ATWATER

DESIGN SERVICES AGREEMENT

1. PARTIES AND DATE.

This Agreement is made and entered into as ________________, 20____ by and between the City of Atwater, a public agency organized and operating under the laws of the State of California with its principal place of business at ____________________ (“City”), and [***INSERT NAME***], a [***INSERT TYPE OF ENTITY - CORPORATION, PARTNERSHIP, SOLE PROPRIETORSHIP OR OTHER LEGAL ENTITY***] with its principal place of business at [***INSERT ADDRESS***] (hereinafter referred to as “Designer”). City and Designer are sometimes individually referred to herein as “Party” and collectively as “Parties.”

2. RECITALS.

2.1 City. City is a municipal corporation organized under the laws of the State of California, with power to contract for services necessary to achieve its purpose.

2.2 Designer. Designer desires to perform and assume responsibility for the provision of certain professional design services required by the City on the terms and conditions set forth in this Agreement. Designer warrants that it is fully licensed, qualified, and willing to perform the services required by this Agreement; provided, however, that if Designer is a corporation or other organization, the Project Designer designated pursuant to Section 3.2, and not the Designer itself, shall be fully licensed to practice as an architect and/or engineer in the State of California.

2.3 Project. City desires to engage Designer to render such services on an on-call basis. Services shall be ordered by Task Order(s) to be issues pursuant to this Agreement for future projects as set forth herein (each such project shall be designated a “Project” under this Agreement).

3. TERMS

3.1 Employment of Designer.

3.1.1 Scope of Services. Designer promises and agrees to furnish to City all labor, materials, tools, equipment, services, and incidental and customary work necessary to fully and adequately supply the professional design and related services necessary for the full and adequate completion of the Project consistent with the provisions of this Agreement (hereinafter referred to as “Services”). The Services shall be more particularly described in the individual Task Order issued by the District’s General Manager or designee. No Service shall be performed unless authorized by a fully executed Task Order in the form attached hereto as Exhibit “D”. All

2 Services shall be subject to, and performed in accordance with, this Agreement, the relevant Task Order, the exhibits attached hereto and incorporated herein by reference, and, as is consistent with the generally accepted professional standard of care, applicable local, state and federal laws, rules and regulations. All Services performed by Designer shall be subject to the sole and discretionary approval of the City, which approval shall not be unreasonably withheld. [INSERT IF FEDERAL FUNDS WILL BE USED; OTHERWISE ALWAYS DELETE: Additionally, Designer shall comply with all Federal requirements applicable to the Services as set forth in Exhibit “A-I.”]

3.1.2 Term. The term of this Agreement shall be from [INSERT DATE] to [INSERT DATE], unless earlier terminated as provided herein. [***INSERT THE FOLLOWING

SENTENCE FOR MULTI-YEAR, AUTOMATIC RENEWAL NOT TO EXCEED THREE CONSECUTIVE YEARS; OTHERWISE, ALWAYS DELETE: The City shall have the unilateral option, at its sole discretion, to renew this Agreement for no more than [INSERT NUMBER] additional one-year terms.***] Designer shall complete the Services within the term of this Agreement, and shall meet any other established schedules and deadlines set forth in the applicable Task Order.

3.2 Project Designer; Key Personnel.

3.2.1 Project Designer. Designer shall name a specific individual to act as Project Designer, subject to the approval of City. Designer hereby designates [INSERT NAME OF INDIVIDUAL DESIGNER] (License No. [INSERT NUMBER]) to act as the Project Designer for the Project. The Project Designer shall: (1) maintain oversight of the Services; (2) have full authority to represent and act on behalf of the Designer for all purposes under this Agreement; (3) supervise and direct the Services using his or her best skill and attention; (4) be responsible for the means, methods, techniques, sequences and procedures used for the Services; (5) adequately coordinate all portions of the Services; and (6) act as principal contact with City and all contractors, consultants, engineers and inspectors on the Project. Any change in the Project Designer shall be subject to the City’s prior written approval, which approval shall not be unreasonably withheld. The new Project Designer shall be of at least equal competence as the prior Project Designer. In the event that City and Designer cannot agree as to the substitution of a new Project Designer, City shall be entitled to terminate this Agreement for cause.

3.2.2 Key Personnel. In addition to the Project Designer, Designer has represented to the City that certain additional key personnel, engineers and consultants will perform the Services under this Agreement. Should one or more of such personnel, engineers or consultants become unavailable, Designer may substitute others of at least equal competence upon written approval of the City. In the event that City and Designer cannot agree as to the substitution of key personnel, engineers or consultants, City shall be entitled to terminate this Agreement for cause. As discussed below, any personnel, engineers or consultants who fail or refuse to perform the Services in a manner acceptable to the City, or who are determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project or a threat to the safety of persons or property, shall be promptly removed from the Project by the Designer at the request of the City. The key additional personnel, engineers and consultants for performance of this Agreement are as follows: [INSERT NAMES, AND TITLES OF KEY PERSONNEL, AND LICENSE NUMBERS, IF APPLICABLE].

3.3 Hiring of Consultants and Personnel.

3.3.1 Right to Hire or Employ. Designer shall have the option, unless City objects in writing after notice, to employ at its expense architects, engineers, experts or other consultants

3 qualified and licensed to render services in connection with the planning and/or administration of the Project, and to delegate to them such duties as Designer may delegate without relieving Designer from administrative or other responsibility under this Agreement. Designer shall be responsible for the coordination and cooperation of Designer’s architects, engineers, experts or other consultants. All consultants, including changes in consultants, shall be subject to approval by City in its sole and reasonable discretion. Designer shall notify City of the identity of all consultants at least fourteen (14) days prior to their commencement of work to allow City to review their qualifications and approve to their participation on the Project in its sole and reasonable discretion.

3.3.2 Qualification and License. All architects, engineers, experts and other consultants retained by Designer in performance of this Agreement shall be qualified to perform the Services assigned to them, and shall be licensed to practice in their respective professions, where required by law.

3.3.3 Standards and Insurance. All architects, engineers, experts and other consultants hired by Designer shall be required to meet all of the same standards and insurance requirements set forth in this Agreement, unless other standards or requirements are approved by the City in writing. Unless changes are approved in writing by the City, Designer’s agreements with its consultants shall contain a provision making them subject to all provisions stipulated in this Agreement.

3.3.4 Assignments or Staff Changes. Designer shall promptly obtain written City approval of any assignment, reassignment or replacement of such architects, engineers, experts and consultants, or of other staff changes of key personnel working on the Project. As provided in the Agreement, any changes in Designer’s consultants and key personnel shall be subject to approval by City.

3.3.5 Draftsman and Clerical Support. Draftsmen and clerical personnel shall be retained by Designer at Designer’s sole expense.

3.4 Standard of Care.

3.4.1 Standard of Care. Designer shall perform all Services under this Agreement in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals qualified to perform the Services in the same discipline in the State of California, and shall be responsible to City for damages sustained by the City and delays to the Project as specified in the indemnification provision of this Agreement. Without limiting the foregoing, Designer shall be fully responsible to the City for any increased costs incurred by the City as a result of any such delays in the design or construction of the Project. Designer represents and maintains that it is skilled in the professional calling necessary to perform the Services. Designer warrants and represents that all of its employees, architects, engineers, experts and other consultants shall have sufficient skill and experience to perform the Services assigned to them. Finally, Designer represents that it, its employees, architects, engineers, experts and other consultants have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services assigned to or rendered by them and that such licenses and approvals shall be maintained throughout the term of this Agreement. As provided for in the indemnification provisions of this Agreement, Designer shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Designer’s failure to comply with the standard of care provided for herein.

4 3.4.2 Performance of Employees. Any employee or consultant who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project, a threat to the safety of persons or property, or any employee or consultant who fails or refuses to perform the Services in a manner acceptable to the City, shall be promptly removed from the Project by the Designer and shall not be re-employed to perform any of the Services or to work on the Project.

3.5 Laws and Regulations.

3.5.1 Knowledge and Compliance. Designer shall keep itself fully informed of and in compliance with all applicable local, state and federal laws, rules and regulations in any manner affecting the performance of the Services or the Project, and shall give all notices required of the Designer by law. Designer shall be liable, pursuant to the standard of care and indemnification provisions of this Agreement, for all violations of such laws and regulations in connection with its Services. If the Designer performs any work knowing it to be contrary to such laws, rules and regulations, Designer shall be solely responsible for all costs arising therefrom.

Designer shall defend, indemnify and hold City, its officials, officers, employees and agents free and harmless, pursuant to the indemnification provisions of this Agreement, from any claim or liability arising out of any failure or alleged failure to comply with such laws, rules or regulations.

3.5.2 Drawings and Specifications. Designer shall cause all drawings and specifications to conform to any applicable requirements of federal, state and local laws, rules and regulations, including the Uniform Building Code, in effect as of the time the drawings and specifications are prepared or revised during the latest phase of the Services described in Exhibit “A” attached hereto. Any significant revisions made necessary by changes in such laws, rules and regulations after this time may be compensated as Additional Services which were not known or reasonably should not have been known by Designer. Designer shall cause the necessary copies of such drawings and specifications to be filed with any governmental bodies with approval jurisdiction over the Project, in accordance with the Services described in Exhibit “A” attached hereto. For the preparation of all such drawings and specifications, the Designer shall use Computer Aided Design Drafting (“CADD”) (e.g., AutoCAD) or other technology acceptable to the Designer and City.

3.5.3 Americans with Disabilities Act. Designer will use its best professional efforts to interpret all applicable federal, state and local laws, rules and regulations with respect to access, including those of the Americans with Disabilities Act (“ADA”). Designer shall inform City of the existence of inconsistencies of which it is aware or reasonably should be aware between federal and state accessibility laws, rules and regulations, as well as any other issues which are subject to conflicting interpretations of the law, and shall provide the City with its interpretation of such inconsistencies and conflicting interpretations. Unless Designer brings such inconsistencies and conflicting interpretations to the attention of the City and requests City’s direction on how to proceed, the Designer’s interpretation of such inconsistencies and conflicting interpretations shall be the sole responsibility and liability of Designer, and the Designer shall correct all plans, specifications and other documents prepared for the Project at no additional cost if its interpretations are shown to be incorrect. In the event that the Designer request’s City’s direction on how to proceed with respect to any inconsistent and/or conflicting interpretation, the Designer shall be responsible to the City only pursuant to the indemnification provisions of this Agreement.

3.5.4 Permits, Approvals and Authorizations. Designer shall provide City with a list of all permits, approvals or other authorizations required for the Project from all federal, state

5 or local governmental bodies with approval jurisdiction over the Project. Designer shall then assist the City in obtaining all such permits, approvals and other authorizations. The costs of such permits, approvals and other authorizations shall be paid by the City.

3.5.5 Water Quality Management and Compliance.
(a) Compliance with Water Quality Laws, Ordinances and Regulations.

Designer shall keep itself and all subcontractors, staff, and employees fully informed of and in compliance with all local, state and federal laws, rules and regulations that may impact, or be implicated by the performance of the Services including, without limitation, all applicable provisions of the City’s ordinances regulating water quality and storm water; the Federal Water Pollution Control Act (33 U.S.C. § 1251 et seq.); the California Porter-Cologne Water Quality Control Act (Cal Water Code §§ 13000-14950); and any and all regulations, policies, or permits issued pursuant to any such authority. Designer shall additionally comply with the lawful requirements of the City, and any other municipality, drainage district, or other local agency with jurisdiction over the location where the Services are to be conducted, regulating water quality and storm water discharges.
(b) Standard of Care. Designer warrants that all employees and subcontractors shall have sufficient skill and experience to perform the work assigned to them without impacting water quality in violation of the laws, regulations and policies described in Sections 3.5.5(a) of this Agreement. Designer further warrants that it, its employees and subcontractors will receive adequate training, as determined by the City, regarding these requirements as they may relate to the Services.
(c) Liability for Non-compliance.
(i) Indemnity: Failure to comply with laws, regulations, and ordinances listed in Sections 3.5.5(a) of this Agreement is a violation of federal and state law.

Notwithstanding any other indemnity contained in this Agreement, Designer agrees to indemnify and hold harmless the City, its officials, officers, agents, employees and authorized volunteers from and against any and all claims, demands, losses or liabilities of any kind or nature which the City, its officials, officers, agents, employees and authorized volunteers may sustain or incur for noncompliance with the laws, regulations, and ordinances listed above, arising out of or in connection with the Services, except for liability resulting from the sole established negligence, willful misconduct or active negligence of the City, its officials, officers, agents, employees or authorized volunteers.
(ii) Defense: City reserves the right to defend any enforcement action or civil action brought against the City for Designer’s failure to comply with any applicable water quality law, regulation, or policy. Designer hereby agrees to be bound by, and to reimburse the City for the costs associated with, any settlement reached between the City and the relevant enforcement entity.
(iii) Damages: City may seek damages from Designer for delay in completing the Services caused by Designer’s failure to comply with the laws, regulations and policies described in Section 3.5.5(a) of this Agreement, or any other relevant water quality law, regulation, or policy.

3.6 Independent Contractor.

6 3.6.1 Control and Payment of Subordinates. City retains Designer on an independent contractor basis and Designer is not an employee of City. Designer is not an employee for state tax, federal tax or any other purpose, and is not entitled to the rights or benefits afforded to City’s employees. Any additional personnel performing the Services under this Agreement on behalf of Designer shall also not be employees of City, and shall at all times be under Designer’s exclusive direction and control. Designer shall pay all wages, salaries, and other amounts due such personnel in connection with their performance of Services under this Agreement and as required by law. Designer shall be responsible for all reports and obligations respecting such additional personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, disability insurance, and workers’ compensation insurance.

3.7 Schedule of Services.

3.7.1 Designer Services. Designer shall fully and adequately complete the Services described in this Agreement and in Exhibit “A” attached hereto and incorporated herein by reference.

3.7.2 Timely Performance Standard. Designer shall perform all Services hereunder as expeditiously as is consistent with professional skill and care, as well as the orderly progress of the Project work so as not to be the cause, in whole or in part, of delays in the completion of the Project or in the achievement of any Project milestones, as provided herein.

Specifically, Designer shall perform its Services so as to allow for the full and adequate completion of the Project within the time required by the City and within any completion schedules adopted for the Project. Designer agrees to coordinate with City’s staff, contractors and consultants in the performance of the Services, and shall be available to City’s staff, contractors and consultants at all reasonable times.

3.7.3 Performance Schedule. Designer shall prepare an estimated time schedule for the performance of Designer’s Services, to be adjusted as the Project proceeds.

Such schedule shall be subject to the City’s review and approval, which approval shall not be unreasonably withheld, and shall include allowances for periods of time required for City’s review and approval of submissions, and for approvals of authorities having jurisdiction over Project approval and funding. If City and Designer cannot mutually agree on a performance schedule, City shall have the authority to immediately terminate this Agreement. The schedule shall not be exceeded by Designer without the prior written approval of City. If the Designer’s Services are not completed within the time provided by the agreed upon performance schedule, or any milestones established therein, it is understood, acknowledged and agreed that the City will suffer damage for which the Designer will be responsible pursuant to the indemnification provision of this Agreement.

3.7.4 Excusable Delays. Any delays in Designer’s work caused by the following shall be added to the time for completion of any obligations of Designer: (1) the actions of City or its employees; (2) the actions of those in direct contractual relationship with City; (3) the actions of any governmental agency having jurisdiction over the Project; (4) the actions of any parties not within the reasonable control of the Designer; and (5) any act of God or other unforeseen occurrence not due to any fault or negligence on the part of Designer. Neither the City nor the Designer shall be liable for damages, liquidated or otherwise, to the other on account of such delays. Designer’s only remedy for such delays shall be a non-compensable extension of time to complete the Services.

7 3.7.5 Request for Excusable Delay Credit. The Designer shall, within fifteen (15) calendar days of the beginning of any excusable delay, notify the City in writing of the causes of delay (unless City grants in writing a further period of time to file such notice prior to the date of final payment under the Agreement). City will then ascertain the facts and the extent of the delay, and grant an extension of time for completing the Services when, in its sole judgment, the findings of fact justify such an extension. The City’s findings of fact thereon shall be final and conclusive on the parties. Extensions of time shall apply only to that portion of the Services affected by the delay and shall not apply to other portions of the Services not so affected. The sole remedy of Designer for extensions of time shall be an extension of the performance time at no cost to the City. If Additional Services are required as a result of an excusable delay, the parties shall mutually agree thereto pursuant to the Additional Services provision of this Agreement. Should Designer make an application for an extension of time, Designer shall submit evidence that the insurance policies required by this Agreement remain in effect during the requested additional period of time.

3.8 Additional Designer Services.

3.8.1 Request for Services. At City’s request, Designer may be asked to perform services not otherwise included in this Agreement, not included within the basic services listed in Exhibit “A” attached hereto, and/or not customarily furnished in accordance with generally accepted design practice.

3.8.2 Definition. As used herein, “Additional Services” mean: (1) any work which is determined by City to be necessary for the proper completion of the Project, but which the parties did not reasonably anticipate would be necessary for the Designer to perform at the execution of this Agreement; or (2) any work listed as Additional Services in Exhibit “A” attached hereto. Designer shall not perform, nor be compensated for, Additional Services without prior written authorization from City and without an agreement between the City and Designer as to the compensation to be paid for such services. City shall pay Designer for any approved Additional Services, pursuant to the compensation provisions herein, so long as such services are not made necessary through the fault of Designer pursuant to the indemnification provision of this Agreement.

3.8.3 Examples of Additional Services. Such Additional Services shall not include any redesign or revisions to drawings, specifications or other documents when such revisions are necessary in order to bring such documents into compliance with applicable laws, rules, regulations or codes of which Designer was aware or should have been aware pursuant to the laws and regulations provision of this Agreement above. Such Additional Services may include, but shall not be limited to:
(a) Separately Bid Portions of Project. Plan preparation and/or administration of work on portions of the Project separately bid. (b) Furniture and Interior Design. Assistance to City, if requested, for the selection of moveable furniture, equipment or articles which are not included in the Construction Documents.
(c) Fault of Contractor. Services caused by delinquency, default or insolvency of contractor, or by major defects in the work of the contractor, provided that any such services made necessary by the failure of Designer to detect and report such matters when it reasonably should have done so shall not be compensated.

8 (d) Inconsistent Approvals or Instructions. Revisions in drawings, specifications or other documents when such revisions are inconsistent with written approvals or instructions previously given and are due to causes beyond the control of Designer. (e) Legal Proceedings. Serving as an expert witness on City's behalf or attending legal proceedings to which the Designer is not a party. (f) Damage Repair. Supervision of repair of damages to any structure. (g) Extra Environmental Services. Additional work required for environmental conditions (e.g. asbestos or site conditions) not already contemplated within the Designer's services for the Project.

3.9 City Responsibilities. City’s responsibilities shall include the following:

3.9.1 Data and Information. City shall make available to Designer all necessary data and information concerning the purpose and requirements of the Project, including scheduling and budget limitations, objectives, constraints and criteria. As part of the budget limitation information, the City shall provide the Designer with a preliminary construction budget (“City’s Preliminary Construction Budget”).

3.9.2 Project Survey. If required pursuant to the scope of the Project and if requested by Designer, City shall furnish Designer with, or direct Designer to procure at City’s expense, a survey of the Project site prepared by a registered surveyor or civil engineer, any other record documents which shall indicate existing structures, land features, improvements, sewer, water, gas, electrical and utility lines, topographical information and boundary dimensions of the site, and any other such pertinent information.

3.9.3 Bid Phase. Distribute Construction Documents to bidders and conduct the opening and review of bids for the Project.

3.9.4 Testing. Retain consultant(s) to conduct chemical, mechanical, soils, geological or other tests required for proper design of the Project, and furnish such surveys, borings, test pits, and other tests as may be necessary to reveal conditions of the site which must be known to determine soil condition or to ensure the proper development of the required drawings and specifications.

3.9.5 Required Inspections and Tests. Retain consultant(s) to conduct materials testing and inspection or environmental/hazardous materials testing and inspection pursuant to any applicable laws, rules or regulations.

3.9.6 Fees of Reviewing or Licensing Agencies. Directly pay or reimburse the payment of all fees required by any reviewing or licensing agency, or other agency having approval jurisdiction over the Project.

3.9.7 City’s Representative. The City hereby designates the City Manager, or his or her designee, to act as its representative for the performance of this Agreement (“City’s Representative”). City’s Representative shall have the power to act on behalf of the City for all purposes under this Contract. The City Manager hereby designates [INSERT NAME AND TITLE], or his or her designee, as the City’s contact for the implementation of the Services

9 hereunder. Contractor shall not accept direction or orders from any person other than the City’s Representative or his or her designee.

3.9.8 Review and Approved Documents. Review all documents submitted by Designer, including change orders and other matters requiring approval by the City Council or other officials. City shall advise Designer of decisions pertaining to such documents within a reasonable time after submission, so as not to cause unreasonable delay as provided in the excusable delay provisions of this Agreement above.

3.10 Compensation.

3.10.1 Designer’s Compensation for Basic Services. City shall pay to Designer, for the performance of all Services rendered under this Agreement, the total not to exceed amount set forth in each Task Order (“Total Compensation”). This Total Compensation amount shall be based upon, and may be adjusted according to, the fee schedule and related terms and conditions attached hereto as Exhibit “B” and incorporated herein by reference. The Total Compensation, as may be adjusted upon mutual agreement, shall constitute complete and adequate payment for Services under this Agreement.

3.10.2 Payment for Additional Services. At any time during the term of this Agreement, City may request that Designer perform Additional Services. As used herein, Additional Services means any work which is determined by City to be necessary for the proper completion of the Project, but which the Parties did not reasonably anticipate would be necessary at the execution of this Agreement. Any additional work in excess of this amount must be approved by the City. If authorized, such Additional Services will be compensated at the rates and in the manner set forth in Exhibit “C” attached hereto and incorporated herein by reference, unless a flat rate or some other form of compensation is mutually agreed upon by the parties. If City requires Designer to hire consultants to perform any Additional Services, Designer shall be compensated therefore at the rates and in the manner set forth in Exhibit “C” attached hereto and incorporated herein by reference, unless a flat rate or some other form of compensation is mutually agreed upon by the parties. City shall have the authority to review and approve the rates of any such consultants. In addition, Designer shall be reimbursed for any expenses incurred by such consultants pursuant to the terms and conditions of Section 3.10.3.

3.10.3 Reimbursable Expenses. Reimbursable expenses are in addition to compensation for the Services and Additional Services. Designer shall not be reimbursed for any expenses unless authorized in writing by City, which approval may be evidenced by inclusion in Exhibit “C” attached hereto. Such reimbursable expenses shall include only those expenses which are reasonably and necessarily incurred by Designer in the interest of the Project. Designer shall be required to acquire prior written consent in order to obtain reimbursement for the following: (1) extraordinary transportation expenses incurred in connection with the Project; (2) out-of-town travel expenses incurred in connection with the Project; (3) fees paid for securing approval of authorities having jurisdiction over the Project; (4) bid document duplication costs in excess of $1,000; and (5) other costs, fees and expenses in excess of $1,000.

3.10.4 Payment to Designer. Designer’s compensation and reimbursable expenses shall be paid by City to Designer no more often than monthly. Such periodic payments shall be made based upon the percentage of work completed, and in accordance with the phasing and funding schedule provided in Exhibit “B” and the compensation rates indicated in Exhibit “C” attached hereto and incorporated herein by reference. In order to receive payment, Designer shall present to City an itemized statement which indicates Services performed, percentage of