Waste Management Program fact sheet
Division of Environmental Quality Director: Ed Galbraith
PUB2441

Region Identification Letter (A-T)
Fill in the letter assigned to the Solid Waste Management Region.

District Chairperson’s Name
Fill in the name of the Executive Board chairperson.

Page number
Enter number such as 1 of 1.

District Name
This is the official name of the Solid Waste Management District. The department recommends the official name of the district appear on each document submitted.

Number of Projects This Submission
Fill in the number of projects that will be included in this submission.

District’s Federal ID
Indicate the district’s Federal ID number.

Fiscal Year
Indicate the state fiscal year for which the application is being submitted. The state fiscal year is July through June. 1.

1. Project Number
Fill in the number assigned to the project by the district. The number should begin with the Region Identification (i.e., A - T), followed by the four digit fiscal year, and three digit project number. An example would be Project Number A2013-001. Attach additional sheets if necessary.

2. DO, PI, or CC
Write in if the project is for District Operations, Plan Implementation or a City/County grant.

3. Area Served
List the county area the project serves or for a district-wide project state “district-wide.” For District Operations list the county where the district’s administrative office is located.

4. Total Project Award
This column will calculate when Columns 5 through 8 are entered.

5. District Carryover (At District)
Fill in the amount of district carryover on hand at the district to fund the project.

6. Interest Income (At District)
Fill in the amount of interest income on hand at the district to fund the project.

7. Program Income (At District/ Subgrantee)
Fill in the amount of program income on hand at the district or held by the subgrantee to fund the project.

8. Department of Natural Resources Remittable Allocation
Fill in the amount of department remittable allocation (i.e., cash) requested from the Solid Waste Management Program for the submitted projects.

Note: Adding or deleting lines may affect the formulas used to calculate the following totals. The preparer will want to verify the formulas remain accurate. After carefully completing the form, the district chairperson is responsible for certifying the grant award process by signing and dating the bottom of the form.


Nothing in this document may be used to implement any enforcement action or levy any penalty unless promulgated by rule under chapter 536 or authorized by statute.


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