2009 SCALE application

Application for Financial Assistance through SCALE

Application Information

Organization:

Contact Name: First
Last

Email:

Telephone:
Extension

Fax:

Address 1:

Address 2:

City:
State:
Zip:

History of Past Events

For the purpose of this application an “event” is defined as all clean up days within a calendar year.

Number of Years Event Held:

Single-day Event:
Yes
No

Number of clean up days per year:

If your organization holds multiple events in a calendar year, combine the event totals and report them as a single year event as follows:

For Date - use the date of the first event.
For the "Miles or Acres" and "Participants" - enter the total of all of the events held within one calendar year.

Provide event information for your organization's last three events.
	Example	Event 1	Event 2	Event 3
Date	May 13,2008
Miles or Acres	10 Miles
Participants	60

Comments:

Upcoming Event Information

Event Date:

Additional Clean Up Dates:

Waterbody Involved:

Event Partners:

Event Location - List County(s):

Our SCALE event is part of a MS4 Stormwater Managemental Plan or another program required by state or federal law*:
Yes
No

*The SCALE program is funded under Section 319 of the Clean Water Act. SCALE funds cannot be used to implement any program that is required by State or Federal law. This includes activites identified as part of a stormwater management program to meet requirements for a Phase II General Stormwater Permit for small municipal Separate Storm Sewer Systems(MS4).

Questions or Comments?

Refer questions or comments regarding the SCALE program to Illinois EPA Nonpoint Source Unit at (217) 782-3362

Illinois EPA is authorized to require this information under 415 ILCS 5/4(k). Disclosure of this information is required. Failure to do so may prevent this form from being processed and could result in your application being denied.

Agency Links

Info Centers

Water Pollution Control

Application for Financial Assistance through SCALE

The application period closes on November 30^th
SCALE Funds will be available after February 1^st

Water Menu

Agency Links

Info Centers

Water Pollution Control

Application for Financial Assistance through SCALE

The application period closes on November 30th SCALE Funds will be available after February 1st

Water Menu

The application period closes on November 30^th
SCALE Funds will be available after February 1^st