HomeMy WebLinkAboutFY2022_205j_ApplicationSubmit the completed application as a Word document to rishi.bastakoti@ncdenr.gov with “[Your COG’s name] 205(j) Grant Proposal” in the subject line by Monday, October 3, 2022. Any signed
letters of support may be scanned and included as a separate attachment.
1. Basic Information
Project Title
Project Start Date
Project End Date
Project Abstract
Please limit abstract to the space provided.
205(j) Grant Funds Requested
$
Match (optional, recommended)
$
Total Project Cost
$
2a. Primary Contact or Project Manager
A one-page Statement of Qualifications must be provided in Item 4 to confirm that anyone designing, installing, or monitoring the proposed project is qualified to do so.
Name
Title
Organization Name
Mailing Address
City
State
ZIP
Email Address
Telephone
FAX No.
2b. Administrative Address
Address where contract will be mailed for signature
Name
Title
Organization Name
Mailing Address
City
State
ZIP
Email Address
Telephone
FAX No.
Federal Tax ID Number
2c. Payment Address
Address where invoice payments will be mailed
Name
Title
Organization Name
Mailing Address
City
State
ZIP
Email Address
Telephone
FAX No.
3. Project Partner Information
If further space is needed to adequately describe partners’ role/contribution to project, please include in the Statement of Qualifications (Item 4).
Organization Name
Organization Address
Role/contribution to Project
Contact Person
Phone No.
E-mail address
Organization Name
Organization Address
Role/contribution to Project
Contact Person
Phone No.
E-mail address
Organization Name
Organization Address
Role/contribution to Project
Contact Person
Phone No.
E-mail address
Organization Name
Organization Address
Role/contribution to Project
Contact Person
Phone No.
E-mail address
4. Statement of Qualifications for Project Manager and Primary Partners
Please include qualifications of people, not organizations. Do not copy and paste entire CVs.
Briefly describe relevant experience, noting any relevant 205(j) grant funded projects.
5. Project Area
Results Site-Specific, Regional, or Statewide?
River Basin(s)
Need identified in Basin Plan? (Y/N; note plan name, date, pg#)
Watershed name(s)
Watershed size
square miles
12-digit USGS HUC(s)
(For site-specific projects only)
County
6. Map of Project Area
Please copy map into document as a small image file.
7. General Goal of the Project (per the Clean Water Act Section 604(b)/205(j) grant purpose)
Identify most cost-effective and locally acceptable facility and nonpoint source measure(s) to meet and maintain water quality standards
Develop implementation plan to obtain state and local financial and regulatory commitments to implement measures identified
Determine the nature, extent, and cause of water quality problems in various areas of the state
Other—please specify water quality planning purpose
8. Detailed Description of the Project
Explain how the project will fill a need. Provide detailed information about the approach/method, project outcomes, and specific project deliverables. If developing a Watershed Restoration
Plan, please also complete Item 18.
9. Photos or Diagrams (optional)
Include photos or diagrams if they would supplement project narrative and improve reviewers’ understanding of your project.
10. BIGGER PICTURE BENEFITS
(CO-BENEFITS)
Describe your project’s benefits to each of the items below. If there are no associated benefits type “NA.”
Climate Resilience: Provide a short description on how this project will address climate change impacts (e.g., adapting for more variable rainfall patterns, greater runoff volumes,
longer dry periods; or lower stream flows during dry months and higher stream flow during wet months; or sea level rise and sea water intrusion, etc.).
Benefits to underserved communities: Provide a short description of whether the project is located in underserved communities. If so, discuss whether the underserved communities or
organizations are engaged in the project, and how the project would benefit them. Refer to NCDEQ’s Community Mapping System to determine the location of underserved communities.
Impacts to downstream communities
Other (Specify if any)
11. Project Evaluation
Please describe how you will evaluate whether this project successfully met its outcomes and provided the intended deliverables. Evaluation methods for any information/education activities
should also be identified.
12. Related Projects in the Watershed
Please note any other current or recent projects in the same watershed that contribute to the same goals as the proposed project. These could be your own or partners’ related water quality
planning or implementation projects.
How might these projects benefit or complement the proposed project?
When were they completed?
Who implemented/maintains them?
13. What funding sources exist to implement the results of the project?
14. Project Milestone Schedule
If planning to start the project in the second quarter, the first quarter can be left blank. Please note anticipated dollar amount, percent of grant spent that quarter, and cumulative
percent of grant spent for project. Quarterly invoices will only be reimbursed up to the percent indicated. Unused funds will carry forward to next quarter. Note that 10% of grant will
be held until receipt of Final Project Report.
Quarter
Activities or outputs to be accomplished
Anticipated funds requested
Quarter $
Quarter %
Cumulative $
Cumulative %
Fiscal Year 1
First Quarter
Jan-Mar 2023
Second Quarter
Apr-Jun 2023
Fiscal Year 2
Third Quarter
Jul-Sep 2023
Fourth Quarter
Oct-Dec 2023
Fifth Quarter
Jan-Mar 2024
Sixth Quarter
Apr-Jun 2024
≥10%
14. 15. Funding Requested
*If a significant portion of funding is in contractual line, please break down contractual line items in Item 16.
Budget Categories
(itemize all categories)
Section
205(j) Funds
Please ensure consistency with Milestone funds (Item.14)
Section 205j Funds
Total
Non-Federal
Match (recommended, not required)
Total including match
Justification
Include explanation for each budget line item
Fiscal year 1
(Must equal Quarters 1&2 in Item 14)
Fiscal year 2
(Must equal Quarters 3-6 total in Item 14)
Personnel/ Salary
Fringe Benefits
Supplies
Equipment
Travel
Contractual*
Other
Total Direct
Indirect (max. 10% of direct costs, per
40 CFR 35.268)
Annual Totals
Grand Total
% of Total Budget
%
%
100%
Indirect (facilities and administrative) costs: Administrative costs include salaries, overhead, and direct or indirect costs for services provided and charged against activities and
programs carried out with 205j funds. Only 10 percent of funding in a 205 j grant may be used for administrative costs.
Direct costs: Direct costs are costs directly related to accomplishing the project, and they may include administrative costs. Direct costs include personnel, the purchase of equipment,
supplies, materials, contracts, and travel.
Equipment only refers to items that cost at least $5,000. Anything that costs less than $5,000 will be categorized as supplies.
16. Contractual budget (if applicable)
If a significant portion of funding is in contractual line, please break down contractual line items here.
Budget Categories
(itemize all categories)
Section
205(j)
Non-Federal
Match (recommended, but not required)
Total
Justification
(Include explanation for each budget line item)
Year 1
Year 2
Personnel/Salary
Fringe Benefits
Supplies
Equipment
Travel
Contractual
Other
Total Direct
Indirect (max. 10% of direct costs, per
40 CFR 35.268)
Annual Totals
Grand Total
% of Total Budget
%
%
100%
17. Match summary (if applicable - recommended, but not required)
Total Match amount
$
Cash Match
$
Source(s):
In-kind Match
$
Source(s):
18. 9-Element Plan Sources (only for applicants developing a 9-Element Watershed Restoration Plan)
Please indicate below what sources you will use to find or develop the information necessary to meet EPA’s 9 Key Elements.
1
An identification of the causes and sources or groups of similar sources that will need to be controlled to achieve needed load reductions
2
A description of the NPS management measures that will need to be implemented to achieve load reductions and other watershed goals identified in the plan
3
An estimate of the load reductions expected from the management measures
4
An estimate of the amount of technical and financial assistance needed, associated costs, and/or sources and authorities that will be relied upon to implement the plan
5
An information/education component that will be used to enhance public understanding of the project and encourage participation
6
A schedule for implementing the NPS management measures identified in the plan that is reasonably expeditious
7
A description of interim, measurable milestones for determining whether NPS management measures or other control actions are being implemented
8
A set of criteria that can be used to determine whether loading reductions are being achieved over time and substantial progress is being made toward attaining water quality standards
9
A monitoring component to evaluate the effectiveness of the implementation efforts over time, measured against the criteria established under item 8.
If you have questions or need assistance filling out this application, please do not hesitate to contact Rishi Bastakoti at (919) 707-3623 or rishi.bastakoti@ncdenr.gov.