2014 4 Loca al Sou urce Water W r Prottection n Graant App plicatiion

Bu ureau for Public Health, Office O of Environ nmental H Health Seervices

Appllication n Deadlline: F Februarry 1, 2014

West Virginia Department of Health and Human Resources Bureau for Public Health, Office of Environmental Health Services

2014 Local Wellhead and Source Water Protection Grant Application Application Deadline: February 1, 2014 FUNDING AVAILABILITY The West Virginia Department of Health and Human Resources (WVDHHR), Bureau for Public Health (BPH), Office of Environmental Health Services (OEHS) is pleased to announce the 2014 Local Wellhead Protection Grant Program. This Wellhead Protection Grant Program is only for groundwater or groundwater under the direct influence (GWUDI) systems. Approximately $50,000 will be available for distribution to multiple grantees during a one year grant period. Awards to selected applicants proposing eligible activities may be from $1,000 to $10,000. However, an applicant may be awarded amounts outside of this range depending upon the quality of the proposed activities, total funding requested, and funding availability. OEHS is responsible for establishing and maintaining the state Wellhead Protection (WHP) Program and Source Water Assessment and Protection (SWAP) Program. The WHP Program is designed to be community-based, given that local stakeholders are in the best position to decide how to protect their community’s water supply. This allows a great deal of flexibility in designing and implementing local WHP programs to protect existing or planned groundwater sources. This grant program uses funding from the Federal106 Waste Pollution Control Program grant to help the implementation of the Wellhead and Source Water Protection Grant program. Applicant should read this packet carefully. This packet provides:  Information on eligibility, submission requirements, potential projects, and the selection process.  Instructions for completing the grant application (Attachment A).  Guidelines for complying with invoicing, reporting, and auditing rules (Attachment B).  Guidelines for complying with Disadvantaged Business Enterprise requirements (Attachment C).

ELIGIBLE APPLICANTS Eligible applicants for WHP grants are groundwater community water systems; a group of adjacent community water systems; or county commissions or county planning commissions representing a community water system. Individuals, private firms, unincorporated citizen groups, or county, state, and federal government units that are not operating or representing a community water system are NOT eligible for grants under this program. However, interested parties may enter into working arrangements with eligible applicants.

Completed applications must be received at OEHS by 5:00 pm February 1, 2014, in order to be considered for funding this period. Applications can be mailed to: Crystal Hubbard, Geologist II OEHS/Environmental Engineering Division 350 Capitol Street, Room 313 Charleston, West Virginia 25301-3713

SUBMISSION REQUIREMENTS T

Applicants must submit one (1) original and three (3) copies, unbound for reproduction purposes. NO FAXES OR E-MAILS WILL BE ACCEPTED.

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Projects must address active or planned sources for public water systems utilizing groundwater. A planned source must be proposed in a submitted preliminary permit application. If a planned source is not made active within 6 months from the final selection notification, award negotiations may be terminated to allocate grant funding to be used to protect active sources.

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Projects must propose activities to protect the source water, delineated protection area, raw water intake, or pumping facility for raw water, directly. Projects pertaining to treatment or distribution are not eligible. See “Non-Allowable Costs” for more information.

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Project work plans must be for work completed within the grant period. Work completed outside of the grant period cannot be funded.

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Applicants must agree to abide by Disadvantaged Business Enterprises (DBE) requirements to follow good faith efforts when soliciting for goods or services as described in Attachment C.

GRANT ACTIVITIES The goal of the grant program is to enable groundwater community water systems to plan and conduct activities that will protect their water system. The following are eligible activities. Activities may be performed individually or in conjunction with others. A number of activities listed may not apply to every water system. Applicants should base their proposal on their water system’s specific needs and threats. Activities are in no particular order and there is no guarantee that an application proposing one or more of these activities will automatically be funded.

ACTIVITIES ELIGIBLE FOR GRANT FUNDING Planning Team

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Form a local wellhead protection team, a collection of not less than three persons whose purpose is to facilitate the development, implementation, and maintenance of a WHP Program on a local level. Ideally, the team should include a representative from the Public Water System (PWS) and representative from a community served by the PWS.

Wellhead Protection Area, Wells and Source Water

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Enhance the delineation for the WHP area, by performing any or all of the following: compile existing and collect additional hydrogeologic information, collect static water levels, perform groundwater modeling, including particle tracking, etc. Install sentinel monitoring wells to collect water quantity and quality, if deemed appropriate by the WVDHHR due to the presence of known groundwater contamination within the WHP area of specific systems. Conduct scientific investigation to develop or improve understanding of hydrology for current or future source water use and development. Complete a WHP area delineation for a new well. Develop and implement a WHP program for a new well or well field or incorporate them into an existing WHP program. Update PCS inventory by performing all of the following activities: search records to identify present and historical potential sources of contamination and land uses that have a potential to impact the groundwater; conduct general surveys to identify potential sources of contamination and land uses that have a potential to impact the groundwater; map existing and potential sources of contamination within the WHP area; and develop a plan to inspect and update inventory regularly. Address specific PCS’s, by performing any or all of the following: conduct on-site inspection of facilities that have a potential to impact the groundwater; develop and implement a program to locate and identify abandoned wells within the WHP area; investigate underground storage

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Potential Contaminant Sources (PCSs)

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ACTIVITIES ELIGIBLE FOR GRANT FUNDING Potential Contaminant Sources (cont.)

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Management Strategies

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Contingency Plan & Emergency Response Protocol

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Public Awareness

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   Security Projects

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tanks and leaking underground storage tanks; and/or identify and investigate other specific threats. Design and develop an implementation strategy to prevent non-point source pollution in a WHP area, such as a house and farm hazardous waste collection program including herbicides, pesticides, paint products, auto and farm implement products, and cleaning agents. Develop and implement best management practices that reduce the risk of groundwater contamination. Abandon unused water wells within the WHP area. This must be done by a certified well driller in accordance to WV Legislative Rule 64CSR19: Water Well Regulations, and 64CSR46 Water Well Design Standards. Develop and implement management strategies within the WHP area. Partner with municipality or county government to incorporate a WHP Plan into a comprehensive environmentally-sensitive land use and development planning program. Develop waste reduction strategies targeted for WHP areas. Revise existing ordinances, or develop and adopt ordinances specifically designed to protect sources of drinking water. Establish a program for transferring development rights within a WHP area to land outside of the protection area. Enhance or augment existing public water system and/or local agency Emergency Response Plans to address potential incidents that may impact drinking water quality, including written standard operating procedures and mutual aid agreements. Establish a groundwater monitoring network that serves as an “early-warning” system. Develop a contingency plan for providing alternative water supplies in the event of contamination of a drinking water source. Develop, produce, and circulate public participation and/or educational materials that promote awareness and encourage local support of WHP efforts, these materials may include: flyers, billboards, posters, videos, newsletters, workshops, school curriculum, etc. Develop, prepare, and produce media announcements, such as news releases, newspaper articles and radio announcements. Conduct educational programs that target identified existing or potential contaminant sources; or link specific pollution issues to local WHP concerns. Erect signs that identify the WHP area or promote the concept of WHP, such as storm drain stenciling, construction and placement of road signs. Install fencing, alarms, cameras, locks, and lights to protect wells or raw water facilities. Other structures may be included within fencing, in specific instances where it is clearly indicated doing so is the most prudent means to protect entry to the wellhead. Fencing gates to allow foot or vehicular access to source are eligible.

Provide a site plan showing wellheads, source vulnerability and proposed security features. Other

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Perform other activities related to source water protection not listed above. To check the eligibility of activities not listed or for guidance, please contact program personnel: Crystal Hubbard at (304)356-4297, [email protected] or Scott Rodeheaver at (304)356-4270, [email protected] .

Non-Allowable Costs These costs are not allowed under any circumstances: Ω

Any pre-award expenses incurred by awarded Grantee or representative.

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Construction, including that of water facilities (ex. treatment plant, storage tank, water line, water wells).

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Security measures for water treatment or distribution facilities, including buildings, storage tanks, lines.

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Land acquisition.

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Development or compliance testing associated with new drinking water sources.

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Any activities related to permitting/regulatory requirements for community water system wells (ex. sampling, monitoring, etc.).

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Entertainment.

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Interest payments.

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Food (except that associated with approved travel).

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Meeting and conference registration fees.

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Indirect costs. Costs normally associated with an indirect cost rate, such as administration and rent, must be shown as direct costs that are related and necessary to complete the project.

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Costs associated with lobbying.

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Surface water projects.

SELECTION PROCESS Those applications meeting all submission requirements will be reviewed and prioritized based on need and type of projects. An evaluation will be performed by a committee responsible for scoring each application, separately. The scores from each individual on the evaluation committee will be combined to rank applicants. Applicants will be selected to enter the subrecipient grant agreement process in order of their ranking.

Attachments

Attachment A

Application Form and Instructions

Attachment B

Guidance for OEHS Invoicing, Reporting, and Auditing

Attachment C

DBE Requirements

Did You Remember?

ATTACHMENT A: APPLICATION FORM AND INSTRUCTIONS

West Virginia Department of Health and Human Resources Office of Environmental Health Services 2012 Local Source Water Protection Grant APPLICATIONS ARE TO BE RECEIVED NO LATER THAN 5:00 PM, FEBRUARY 1, 2014 INSTRUCTIONS FOR APPLICATION A) Complete the 2014 Local Source Water Protection Grant Application Form B) Create a Statement of Work on a separate page. Answering the guidance questions, listed below, may assist in developing the Statement of Work. Only answer those that apply to your system and project. 1.

Purpose of Project a. How will the project initiate, continue, or expand on the local SWP Program? b. Who will benefit from the project?

2. Project Benefits and Goals a. What goal is the project attempting to accomplish with respect to SWP? b. What specific threat will be addressed by the project? 3. Project Task/Activities a. What tasks are you going to complete to meet the goals of the project? (List and describe) b. Where will the work be done? c. When are you going to perform the work? (The grant period is for one year, Estimate a timeline for activities based on quarters.) 4. Project Outputs/Outcomes a. What are the end results of the completed work (e.g. workshop, vide, source water plan, raised public awareness, emergency response plan, secure drinking water, etc.)? 5. Additional Information a. Are there special skills or knowledge requirements to complete the project? b. If the project involves equipment, how will equipment address the threat? What are the provisions for long-term maintenance of the equipment? If the project involves security, have you included a site plan showing the source/intake, vulnerability, and proposed security measures. C) Budget Provide a detailed budget using the budget worksheet format provided in Attachment B. For assistance completing the budget worksheet or an electronic copy of the worksheet, contact Crystal Hubbard at 304-356-4297, [email protected] or Scott Rodeheaver at 304-356-4270, [email protected] D) Attach documentation, if applicable: 1. Letter showing local support from landowners, county commissioners, local officials, etc. 2. Resumes detailing qualification of personnel, particularly if special skills or knowledge is required. 3. Other documents that substantiate the need or benefits of the proposed work.

West Virginia Department of Health and Human Resources Office of Environmental Health Services 2014 Local Source Water Protection Grant: Application Form Applicant Organization:

PWSID: AMOUNT REQUESTED: $

Is this organization a community water system? If NO, please list water systems you represent along with Public Water System IDs (PWSIDs):

Type of water source

Groundwater

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GWUDI 

Your Name and Title: Address:

Telephone Number: Fax Number: Email Address:

Please provide a brief description of your project (no more than one or two sentences).

Please attach the detailed Statement of Work, Budget Worksheet (Attachment B), and supporting documentation (ex. letter of support, resumes, maps, photos, designs, and/or graphics as appropriate). Disadvantaged Business Enterprise Requirement Agreement (See Appendix C for complete details) The EPA, from which grant monies are acquired for the 2014 Local Source Water Protection Grant, has established a policy for utilizing Disadvantage Business Enterprises (DBE). The policy requires that recipients of financial assistance through grants, cooperative agreements and loans comply with the six good faith efforts to award a fair share of contracts/procurements to DBEs. I acknowledge the DBE Requirements and agree to complete the six good faith efforts when procuring goods and/or services for grant activities. I understand that the requirement is to solicit and encourage participation from DBEs, but that I am not required to award contracts only to DBEs. Signature: ___________________________________________________ Date: ______________________ APPLICATIONS ARE TO BE RECEIVED NO LATER THAN 5:00 PM, FEBRUARY 1, 2014

ATTACHMENT B: GUIDANCE FOR OEHS INVOICING, REPORTING, AND AUDITING

Guidance for OEHS Invoicing, Reporting, and Auditing Awarded applicants or “Grantees” will be required to adhere to financial practices for budgeting, invoicing, reporting, and auditing. Understanding these guidelines and utilizing the provided Budget Worksheet will aid in the approval process required to reach the Subrecipient Grant Agreement if your project is selected. This document is for information only. REQUIREMENTS for invoicing, reporting, and auditing will be described in the Subrecipient Grant Agreement. In the event these documents are in contradiction, the Grantee must conform to the Subrecipient Grant Agreement.

BUDGET WORKSHEET Applicants shall use the provided budget worksheet format provided in this attachment. This format has been developed by the WV DHHR as part of the Subrecipient Grant Agreement. Utilization of this format will aid in the awarding process for selected applicants.

COST SHARING Cost sharing (i.e., a Grantee supplied match) is not required for 2014 Local SWP Grant. However, the intent of contributing a portion of the proposed cost of services or products (e.g. salary of a Grantee employee for the portion of time working on grant activities) will demonstrate a clear path for implementing proposed activities. Third party in-kind contributions (i.e., donations of time or products) may qualify as cost sharing.

INVOICING This program is strictly a reimbursement program. Grantees shall submit copies of actual cost incurred along with the request for reimbursement in the form of an invoice to the OEHS. Once the invoice has been approved, Grantees will be reimbursed. Payment processing takes approximately thirty (30) to sixty (60) days from initial request for reimbursement until actual payment is received.

REPORTING: Minimum reporting requirements are:

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Quarterly status reports. These are a means to monitor activity. They should be submitted regardless of progress. They may be attached to reimbursement request.

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Final report or letter certifying grant completion. This is due within thirty (30) days after project completion summarizing project, accomplishments, and results. The final report shall also contain a financial summary for the entire project.

If applicable the following may be required:

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SWP Grant Program acknowledgment to be used in brochures, publications, etc. (suggested language will be provided by WV DHHR).

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Water quality data generated during the project. These should be submitted in tabular format and on disk or CD.

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Geographic Information Systems (GIS) project data. These should be submitted in a format approved by the OEHS.

AUDITING: The OEHS reserves the right to audit agreements for the SWP Grant Program in the following manner:

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Review of all project-related records.

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Request other appropriate documentation of grant activities (ex. photographs, meeting agendas/minutes, public awareness materials, or draft/final copies of SWAP Plans or Emergency Response Plans).

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Investigate financial expenditure allowability in relation to grant activities.

Make on-site inspections.

The auditing of agreements is to assure that funds have been expended appropriately and to evaluate the progress and success of the SWP Grant Program. Grantee shall maintain and provide the following records as a minimum to account for grant funds received through a SWP grant:

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Employee Time and Activity Reports.

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Expenditure detail.

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Purchase Invoices.

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Subcontracts.

These records are to be retained for three (3) years after final payment.

QUESTIONS: For questions regarding the grant program or assistance with completing the application contact:

Crystal Hubbard, Geologist II, 304-356-4297, [email protected] Scott Rodeheaver, Assistant SWAP Manager, 304-356-4270, [email protected]

ATTACHMENT C: DBE REQUIREMENTS

DBE REQUIREMENTS According to federal rule 40 CFR Part 33, grant recipients must follow the requirements described below when procuring goods and services with federal funding, including loans and grants.

WHAT IS A DBE? DBE’s or Disadvantaged Business Enterprises are minority-owned, women-owned and small business enterprises. As defined by the US Environmental Protection Agency (EPA), a minority-owned business enterprise (MBE) is a business concern that is: 1. At least 51 percent owned by one or more minority individuals, or in the case of a publicly owned business, at least 51 percent of the stock is owned by one or more minority individuals; and 2. Whose daily business operations are managed and directed by one or more of the minority owners. Likewise a woman-owned business enterprise (WBE) is a business concern that is, 1. At least 51 percent owned by one or more women, or in the case of a publicly owned business, at least 51 percent of the stock is owned by one or more minority individuals; and 2. Whose daily business operations are managed and directed by one or more of the women owners. There is not a universal definition for small business enterprises. The Small Business Act states that a small business concern is "one that is independently owned and operated and which is not dominant in its field of operation." The law also states that in determining what constitutes a small business, the definition will vary from industry to industry to reflect industry differences accurately. The US Small Business Administration establishes and revises numerical definitions for all for profit industries, and this numerical definition is called a “size standard.” It is almost always stated either as the number of employees or average annual receipts of a business concern. For more information on small business or size standards visit: http://www.sba.gov/services/contractingopportunities/sizestandardstopics/size/index.html

WHAT IS THE REQUIREMENT? The EPA, from which grant monies are acquired for the Wellhead and Source Water Protection Grant Programs, requires that recipients of financial assistance through grants, cooperative agreements and loans award a fair share of contracts/ procurements to DBE’s. For purposes of the policy, subrecipients of financial assistance, such as subgrantees, are included.

HOW DO YOU MAKE A GOOD FAITH EFFORT? Recipients shall ensure, to the fullest extent possible, that good faith efforts are made to utilize small businesses, including those in rural areas, minority-owned firms, and women-owned business enterprises. To accomplish this goal, contractors must demonstrate compliance with the following six (6) good faith efforts: a. b.

c. d. e. f.

Ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities. For Indian Tribal, State and Local Government recipients, this will include placing DBEs on solicitation lists and soliciting them whenever they are potential sources. Make information available on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process. This includes, whenever possible, posting solicitations for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. Consider in the contracting process whether firms competing for large contracts could subcontract with DBEs. For Indian Tribal, State and local Government recipients, this will include dividing total requirements when economically feasible into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process. Encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually. Use the services and assistance of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce. If the prime contractor awards subcontracts, require the prime contractor to take the steps in paragraphs (a) through (e) of this section.

MEETING OUR FAIR SHARE OBJECTIVE In addition to adhering to the good faith efforts, you should contact DBEs by mail 15 days prior to advertising your bid or proposal solicitation. Your correspondence should at least relay possible means of advertisement (i.e. which newspapers) and a range of dates they may expect to find the advertisement. You may provide them with contact information if they wish to be notified prior to the advertisement.

DOCUMENTING EFFORTS TO COMPLY WITH DBE REQUIREMENT The following instructions and DBE Requirement Documentation form are designed to guide your good faith efforts to comply. In order to properly document your efforts you may need to attach: DBE list, notification letters, solicitation letters, DBE bids, and selection criteria.

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Only applicants soliciting services or products are required to follow a process to identify DBE’s. If you are not soliciting for any service or product, mark the first option on the DBE Requirement Documentation form, sign and submit your form with your grant statement of work and/or budget.

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Applicants may contact one or more databases to determine if CERTITFIED DBEs are available to perform proposed activities. Those listed below are sources of DBE information. Contact the database most likely to list DBEs that relate to your grant activities needs. 1. For lists of DBEs, such as engineering and planning consultants or construction contractors, search the WV Department of Transportation website: www.wvdot.com. Select EEO/DBE under “Doing Business” (right hand side). Scroll down to the bottom of the page. Select “DBE listing-Contractor” or “DBE listing-Consultant”. Only those businesses that would normally provide services to the WVDOT will be certified and listed. Services provided to the WVDOT may be similar to your grant activities needs. 2. An additional database is kept by the United States Small Business Association (SBA). You may contact WV, phone (304)623-5631 with your request. Or you may also search the SBA for certified disadvantaged businesses at: http://www.sba.gov/idc/groups/public/documents/wv_clarksburg/wv_8aportfolio.pdf

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Attach list of available DBEs and contact information, resulting from the database searches.

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Document the DBE notification (if applicable) and bid solicitation activities. Attach notification and solicitation letters, if utilized.

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Attach proposal or bid summary provided by DBEs.

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Document whether or not you will contract with a DBE and provide explanation for why or why not. You may need to attach selection criteria.

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Provide additional information which documents assurances that steps were taken to comply with the six (6) good faith efforts.

DBE Requirements Documentation Grantee Organization: __________________________________________________ Project Title: __________________________________________________________________ Check ALL activities that apply: Will not solicit any contractor or supplier for services or products. Have read the provided DBE Requirements, including the EPA’s Good Faith Effort Steps. Contacted at least one of the database providers to search for DBE. Mark all databases that were contacted. United States Small Business Association (US SBA). Melissa Loader, Phone (304)623-5631 ext. 238 WV Department of Transportation website: www.wvdot.com Other: ___________________________________. Contacted DBEs to solicit services or to notify them 15 days prior to legal advertisement for bid or proposals. ATTACH DBE LIST, including contact information, phone call reports, and/or letters produced during solicitation. Did not contact DBE, because: None were available to provide services. Other: ____________________________________________________________________ Received proposals/bids for services from DBEs. ATTACH PROPOSALS AND BIDS Solicited services from DBEs, but received no proposals or bids. Plan to contract with DBE to provide service. Do NOT plan to contract with DBE to provide service, because: Not the low bid Determined DBE does not qualify to complete work Other: ______________________________________________________________________ (May attach list of selection criteria to better explain.) Use this space to describe any other measures taken to meet DBE Requirements.

Signature _______________________________________

Date _____________________________

Did you remember? The checklist below is for applicant use. Applicants may include additional items with applications that are not listed below. Please see INSTRUCTIONS FOR APPLICATION for complete details.

Complete 2014 Local Source Water Protection Grant Application Form. Sign the DBE Requirement Agreement. Describe Water System. Create a Statement of Work. Prepare a budget using the provided format. Attach letters of support. Attach resumes for professionals. Attach other documents that substantiate need or benefit of proposed activities.

APPLICATIONS ARE TO BE RECEIVED NO LATER THAN 5:00 PM, FEBRUARY 1, 2014