Agricultural Water Use Efficiency Cost-Share Application Resource Conservation District, PO Box 147, Somis CA 93066 Phone: 805-764-5132 Contact Information Name: Company name: Phone (work): (mobile): Email: Property Information Location Address: Mailing Address: Total Acreage: Irrigated Acreage: Crop (and acreage): Water Source(s): Annual Water Use: Duration of Irrigation (Summer): (Winter): Frequency of Irrigation (Summer): (Winter): Irrigation System (microsprinkler, drip, furrow, etc.): Management Practices: Please indicate which best management practices (BMPs) you use □ Water bill Water-use Records: □ Flow meter Irrigation Scheduling: □ Water availability System Maintenance: □ Each irrigation Nutrient Management: Sediment Management: □ Tissue test □ Filter Strip Erosion Control: □ Mulch Runoff Control: □ Manage Irrigation □ Soil moisture □ Weekly □ Soil test □ Weather data □ Annually □ Crop advisor □ Settling Pond □ Cover crop □ Irrigation timing □ Soil amendments Other Practices: Page 1 of 2 □ Soil amendments □ Grading or contouring Project Description: Describe the planned irrigation improvement(s). Add attachment if needed. Project Justification: Explain the benefit(s) of these improvement(s). Add attachment if needed. Project Information: Please provide attachments (estimate, water & electric bills, etc.) Project Timeframe: Project Cost Estimate: Current Water Use: Estimated Water Savings: Current Electrical Use: Estimated Electricity Savings: Current Fuel Use: Estimated Fuel Savings: Other Project Benefits: As signatory to this application, I understand that the Resource Conservation District (RCD) must demonstrate that cost-share funded projects have resulted in quantifiable reductions in water and energy use. Therefore, upon request, I agree to provide the RCD the records needed to establish pre- and post-project agricultural water, fuel, and/or electricity use. I am aware that failure to accept or comply with this requirement will constitute grounds for the RCD to reject this application or withdraw cost-share funding. □ I am also aware that the RCD must certify cost-share funded projects as complete. Therefore, I agree to schedule a re-evaluation with the RCD immediately following project completion. I understand that this re-evaluation will incur a fee of up to $995 which I am responsible for paying prior to reimbursement. □ Signature: Date: Page 2 of 2
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