2025.11.01.FDEP_RFI_Drinking_Water.pdf

Florida Department of Environmental Protection

REQUEST FOR INCLUSION ON THE

DRINKING WATER PRIORITY LIST

Form RFI-DW1 Incorporated in subsection 62-552.200 (29), F.A.C. Page 1 of 4 Effective March 9, 2022

Drinking Water State Revolving Fund Program Douglas Building, 3900 Commonwealth Blvd, Tallahassee, Florida 32399-3000

The information in this Request for Inclusion (RFI) application is used to determine project eligibility and priority scoring. The priority score is used to rank projects for placement on the State Revolving Fund (SRF) priority list. Only projects placed on the fundable portion of the priority list receive consideration for a loan. Please note that costs incurred before the adoption of the project on the fundable or waiting portion of the priority list are not eligible for reimbursement.

1. Applicant's Name and Address.

Project Sponsor: Contact Person: Title:

(street address)

(city) (county) (zip code)

(telephone) (ext.) (e-mail)

Contact Person Address (if different):

(street address) (city) (state) (zip code)

2. Name and Address of Applicant's Consultant (if any).

Firm: Contact Person: Title:

(street address)

(city) (zip code)

(telephone) (ext.) (e-mail)

3. Type of Loan Requested in this Application. (select only one loan category and project type)

Planning Loan Design Loan Planning and Design Loan Construction Loan

Project Type: Design/Bid/Build Design/Build (D/B) Construction Manager at Risk (CMR) n 287.055, F.S.

Eligibility for a Loan. In order to be considered for a priority listing, the following conditions must be met:

The subsection 62-552.200(27), F.A.C.

The minimum construction loan amount is $75,000.

The project sponsor must agree to submit biddable plans and specifications within 1-year after execution of the loan agreement to qualify for a combined planning and design loan.

The project is part of a public water system as defined in subsection 62-552.200(28), F.A.C., and may include drinking water supply, storage, transmission, treatment, disinfection, distribution, residuals management, and appurtenant facilities.

REQUEST FOR INCLUSION ON THE DRINKING WATER PRIORITY LIST

Form RFI-DW1 Incorporated in subsection 62-552.200 (29), F.A.C. Page 2 of 4 Effective March 9, 2022

4. Median Household Income, Population and Principal Forgiveness Percentage (PF%). (complete a. through e. below)

a. Median household income (MHI): (current U.S. Census data or verifiable estimates)

b. State median household income (SMHI): (current U.S. Census data)

c. Population (P) served = number of service connections times 2.5 persons per connection to include proposed connections.

d. Is the project sponsor applying for a planning and/or design loan with principal forgiveness? Yes No . If yes, then PF is 50%. Only a sponsor that qualifies as a financially disadvantaged small community is eligible for a planning/ design loan with PF.

e. Is the project sponsor applying for a construction loan with principal forgiveness? Yes No . If yes, then PF% is calculated using the formula: PF% = 1760/9 160 x (MHI/SMHI) 7/4500 x P.

Calculate PF% for a construction loan using the above formula: (minimum 20% and maximum 90%).

If the sponsor is connecting a financially disadvantaged small community as defined below, a maximum 50% PF is available.

Please note that the calculated PF% is an estimate and the actual percentage will be determined by the Department. The amount of loan available with principal forgiveness for a project is dependent upon the amount of funds allocated for the fiscal year.

Eligibility for a loan with principal forgiveness. In order to be considered for a loan with principal forgiveness, the following conditions must be met:

The project sponsor must qualify as a financially disadvantaged small community public water system as defined in Rule 62- 552.200, F.A.C., unless the sponsor is specifically exempted from this requirement.

must be less than the state median household income (SMHI) as reported from the current U.S. Census data or from verifiable estimates, unless the sponsor is specifically exempted from this requirement.

must be less than 10,000 (to include the population from future connections), unless the sponsor is specifically exempted from this requirement.

The project sponsor is allowed only one open loan with principal forgiveness. A loan is deemed open until the final disbursement of the project has been paid by the department.

A project sponsor is eligible for a construction loan with principal forgiveness (maximum 50%) if connecting a community with less than 250 residential wells; an existing public water system with less than 250 service connections; or a separate, non-interconnected public water system owned by the sponsor. The project area must qualify as a financially disadvantaged small community.

A financially disadvantaged community with a population of 10,000 or more is eligible for a construction loan with 20% principal forgiveness if dollars are available after funding all eligible financially disadvantaged small communities.

A project sponsor that is a for-profit entity is not eligible for principal forgiveness.

A construction project for a financially disadvantaged small community that uses a Construction Manager at Risk delivery method is ineligible for principal forgiveness.

5. Interest Rate Percentage.

The interest rate for a loan with the Department is determined using the following formula:

% of MR = 40 x (MHI/SMHI) + 15 % of MR = Percentage of Market Rate.

Calculate and enter the % of MR below:

% of MR for a loan: (35% < % of MR < 75%)

Please note that the calculated % of MR is an estimate and the actual interest rate will be determined by the Department. The interest rate for a loan shall not be less than 0.2 percent.

6. Base Priority Score. Each project shall receive a base priority score (BPS) dependent on the weighted average of its components.

The BPS shall be determined using the below formula where CPS means the component priority score and CCC means component construction cost.

BPS = [CPS1 x CCC1 n x CCCn]/Total Construction Cost

Select each component and component score in Table 1 below that apply to the project, enter the estimated construction costs, and calculate the base priority score.

Component priority scores that are based on contaminant levels must be justified by sample analytical data (see exception in notes at bottom of Table 1). The date of sample collection must be less than 24-months from the submittal date of the Request for Inclusion.

The project sponsor must provide documentation demonstrating that contaminant levels (e.g. disinfection byproducts) cannot be reduced by adjusting system operations, if applicable.

Form RFI-DW1 Incorporated in subsection 62-552.200 (29), F.A.C. Page 3 of 4 Effective March 9, 2022

A compliance-1 category component score of 400 points, if selected in Table 1, must be supported by documentation demonstrating the need for the project; otherwise, a component score of 300 points shall be assigned.

Table 1 Project Component (select all components that apply) Component

Priority Score Component

Construction Cost

Acute Public Health Risk 1a. E-Coli or Fecal Coliform Exceed MCL (62-550.310(5), F.A.C.)

1b. Nitrate, Nitrite, or Total Nitrogen Exceed MCL (62-550.310(1), F.A.C., Table 1) 1c. Lead or Copper Exceed Action Level (62-550.800, F.A.C) 1d. Surface Water Filtration/Disinfection Noncompliance (62-550.817(2), F.A.C.)

800 points

Potential Acute Public Health Risk 2a. Nitrate, Nitrite, or Total Nitrogen 50% of MCL (62-550.310(1), F.A.C., Table 1) 2b. Microbiologicals Exceed MCL (62-550.310(5), F.A.C.)

2c. Surface Water Enhanced Filtration/Disinfection Noncompliance (62-550.817(3), F.A.C.)

2d. State Health Certification of Acute Health Risk, Unregulated Microbiological Contaminant 2e. Violation of Disinfection Requirements (62-555.320(12), F.A.C.)

700 points

Chronic Public Health Risk 3a. Inorganic/Organic Contaminant Exceed MCL (62-550.310(1) & (4), F.A.C., Tables 1,4,5) 3b. Disinfection Byproducts Exceed MCL (62-550.310(3), F.A.C., Table 3) 3c. Radionuclides Exceed MCL (62-550.310(6), F.A.C)

600 points

Potential Chronic Public Health Risk 4a. Inorganic/Organic Contaminant 50% of MCL (62-550.310(1) & (4), F.A.C., Tables 1,4,5) 4b. Disinfection Byproducts 80% of MCL (62-550.310(3), F.A.C., Table 3) 4c. State Health Certification of Chronic Health Risk, Unregulated Chemical Contaminant

500 points

Compliance-1 Projects (documentation must be attached or default to Compliance-2 score) 5a. Infrastructure upgrades to facilities undersized, exceed useful life, or with equipment failures 5b. Insufficient water supply source, treatment capacity, or storage 5c. Water distribution system pressure less than 20 psi 5d. Eliminate dead ends and provide adequate looping in a distribution system 5e. Replace distribution mains to correct continual leaks, pipe breaks, and water outages 5f. New water system or extension of existing system to replace contaminated or low yield wells 5g. Lack of significant safety measures (e.g. chemical containment) 5h. Secondary Contaminant MCL Exceedance (62-550.320, F.A.C.)

5i. Drinking water supply project as defined in 403.8532(9)(a), F.S.

400 points

Compliance-2 Projects 6a. Treatment, Storage, Power, and Distribution Requirements (62-555.320, F.A.C) 6b. Minimum Required Number of Wells (62-555.315(2), F.A.C) 6c. Well Set-back and Construction Requirements (62-555.312 and 62-555.315, F.A.C) 6d. Cross-Connection Control Requirements (62-555.360, F.A.C) 6e. Physical Security Project Documented in a Vulnerability Analysis 6f. Consolidation or regionalization of public water systems 6g. Water or Energy Conservation Project

300 points

7. All Other Projects (including land or public water system acquisition projects) 100 points

Note: Item 2d. and 4c. of Table 1 requires a State Health Officer to complete the If 50% or more of wells meet contaminant levels from Table 1 above, then select the appropriate health risk category in Table 1. Flooded wells and wells under the direct influence of surface water are considered an unregulated microbiological potential acute public health risk and require documentation of occurrence in lieu of sampling data.

7. Affordability Score. The extent of affordability existing in a small community to be served by the project shall be reflected in the priority score. Points shall be awarded based upon two affordability criteria: median household income (MHI) and population (P) served. These points are to be added to the base priority score. Calculate the affordability score using the following formulas:

Affordability Score = (MHI Score + Population Score)

MHI Score = 100 x (1.00 MHI/SMHI), zero < MHI score < 75, rounded to nearest whole number

Population Score = 50.0 - (P/200), population score > zero, rounded to nearest whole number

Form RFI-DW1 Incorporated in subsection 62-552.200 (29), F.A.C. Page 4 of 4 Effective March 9, 2022

8. Water Conservation Score. A project sponsor with a qualifying water conservation project is eligible to receive an additional 100 points added to their base priority score if the sponsor provides a water conservation plan in Conservation Plan Guidelines document number EPA-832-D-98-001, August 6, 1998.

9. Total Priority Score. Total priority score equals the base priority score plus the affordability score. (complete a. through d. below)

a. Base priority score: points.

b. Affordability score: points (> zero).

c. Water Conservation score: points.

d. Total priority score: points (sum of items a. and c.)

10. Estimated Project Cost. (complete a. through i. below) (enter $0 if activity is not applicable)

Project Activity Cost

a. Planning.

b. Design (not applicable if a D/B project).

c. Eligible land (necessary land divided by total land times purchase price).

d. Constr., equip., material, demo. & related procurement (include design if D/B project).

e. Construction contingency (10% of d only applicable for Design/Bid/Build projects).

f. Technical services during construction and after bid opening.

g. Asset management plan per 62-552.700(7), F.A.C.

h. Total project costs (sum of a. through g.).

i. Loan amount requested by the sponsor in this RFI (assume no principal forgiveness).

List all funding sources (including grants for this project):

11. Project Schedule. (complete a. through d. below)

Project Activity (M/D/YY)

a. Submit planning documents.

b. Submit design/bid documents or RFQ/RFP for CMR & D/B projects.

c. Start construction.

d. Complete construction.

12. Project Information. Provide the following information, if applicable.

(select all items below that are attached to this RFI)

Project description, location with lat/long (degrees), water system PWS ID, and project need (this is a required attachment).

Map of city and county limits, existing and proposed service area, and project area (this is a required attachment).

Lab data, lab data with operational records, or substantiated documentation in lieu of lab data for public health risk projects.

Certification of a Public Health Risk form completed by a State Health Officer.

Supporting documentation for projects identified under the Compliance-1 project categories from Table 1 above.

Project schedule showing plans and specs completion within 1-year of the execution date of a planning/design loan.

Supporting documentation if MHI not taken from current U.S. Census data.

Water Conservation Plan in accordance with EPA guidelines.

13. Certification by an Authorized Representative. I certify that this form and attachments have been completed by me or at my direction and that the information presented herein is, to the best of my knowledge, accurate and true.

(signature) (date) (e-mail)

(print name) (print title)

Email the completed RFI form with attachments to SRFRFI@FloridaDEP.gov or mail to the Florida Department of Environmental Protection, State Revolving Fund Program, 3900 Commonwealth Blvd, Tallahassee, Florida 32399-3000.

BRADENTON