Residential Turf Removal Program Application Part 1 - Rebate Reservation (Limited to one (1) rebate per property)

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1 Property Owner: Residential Turf Removal Program Application Part 1 - Rebate Reservation (Limited to one (1) rebate per property) Applicant Information (please print legibly) Contact Person (if different): Day Phone Number: Eve. Phone Number: Mailing Address: City: State: Zip: Property Type: Project Information Total Lot Size: Single Family Home Duplex/Triplex/Fourplex Townhome Property Address: City: State: Zip: Water Service Account Number (MUST include a copy of a recent water bill): Estimate square footage in areas where turf is to be removed: Front: Back: Side: NOTE: Only the property owner can apply. If the account is in another person's name, they must provide a written statement signed by the property owner indicating their approval of the project plus provide a copy of the property tax bill demonstrating ownership. Funding is limited and provided on a first come first served basis and the Program can end at any time and without notice. Please read and understand all of the terms and conditions applicable to your project. DO NOT start your project prior to receiving approval to proceed. How is the turf irrigated now? Automatic sprinklers Manual sprinklers Hand watered Other What type of irrigation controller do you use? Automatic controller Smart controller None Other Project Description: Use the second page of this application to briefly describe your conversion project and sketch your property indicating the areas to be converted. A contractor's proposal and plans is acceptable. How do you plan to complete your project? Self Contractor Other By signing below, the applicant agrees to comply with the program terms and conditions, as well as all the Federal, State and local codes, including covenants, conditions and restrictions, as applicable. The applicant has read, understands and agrees to the terms and conditions of the program in addition to those outlined on this application and certifies that the information on the application is true and correct. Property Owner Signature: Print Name: Disclaimer Golden State Water Company makes no representation or warranty relating to contracted services or products that may be installed in converted areas, including any hazardous substances that may be contained in the product. Removal of turf and installation of water efficient devices does not guarantee reduced water use. This application is for a rebate only as outlined in the Guidelines and Terms and Conditions.. By participating in the program, you waive and release Golden State Water District, and its contractors and agents from any and all claims and causes of acton arising out of the removal of turf and/or the purchase, installation or use of devices in connection with this Turf Removal rebate program. Any claim you may have based upon any defect or failure of performance of a contracted service or device purchased by you should be pursued with the contractor or manufacturer/distributor. Golden State Water Company only enforces the terms and conditions of the Residential Turf Removal Program. The applicant is responsible for complying with all applicable laws, codes, policies, covenants, conditions, and restrictions that may apply. Quality and appearance of the converted area is the responsibility of the applicant. Check with your local building and permit department before starting any project. This is a voluntary program. Rebates will only be provided if all of the terms and conditions have been met. Funding for the program may run out at any time. Submitting a rebate application does NOT guarantee a rebate. If the project is not completed by the date provided to you on the Approval to Proceed letter, you forfeit your rebate. Complete and correct final project information (Part 2) must be RECEIVED on or before the deadline date. Final project information received more than five (5) days after the deadline date, will be returned to the applicant and rebate will NOT be honored. Signature (required) Date: OFFICIAL USE ONLY Received By: Date Received: Sq. Ft. Proposed Approved Reason for Denial: Denied Rebate No.

2 TURF REMOVAL PART 1 PLAN PROJECT DESCRIPTION Please provide a sketch of your current property indictating the areas for turf to be removed and your plans for irrigation conversion, general design, and remaining and new plantings. You may substitute this with a contractors plan and drawings. We understand that projects change as you get into them. This is just to give us an idea of what you are removing and what you plan on changing your landscape to. Project Description (i.e., irrigation conversion, plant types, remaining plants/trees, mulch, rock, pathways, etc.

3 Residential Turf Removal Program Application Part 1 Rebate Request (Limited to one (1) rebate per property) Please include the following when you submit Part 1 Rebate Request 3 recent color photos of each of the turf removal areas for conversion Photos must be in color and show live, maintained turf Photos must be from different angles clearly showing areas Labels and titles of the photos (please write on the pictures) Pictures on printer paper are preferred Turf Removal Project Description Irrigation conversion description Plant list Copy of recent water bill Name on bill must be property owner If not, property owner must supply copy of property tax bill Completed Signed Part 1 - Rebate Reservation Application Part 1 Application may be submitted by to Please compress the picture files or send as PDF. Mail to: Golden State Water Company WUE Turf Removal Program 1920 West Corporate Way Anaheim, CA Responses may take 2 to 3 weeks. Do not start killing or removing turf prior to receiving approval.

4 Residential Turf Removal Program Application Part 2 - Rebate Request (Submit when project is COMPLETE) REBATE # Applicant Name: Best Contact Phone Number and Time to Call: Applicant Information (please print) Property Address: City: State: Zip: Final Square Footage of Turf REMOVED: Where was turf removed from? Front Yard Side Yard Parkway/Easement Other How is the area irrigated now? (Conversion from in-ground sprinkler systems required) Permeable Weed Barrier 2 " Mulch Applied 25% Plant Material Present No. of Stations No. of Days per Week Minutes per Station What type of irrigation controller do you use now -- it is new or did you use existing? New Model Automatic controller Smart controller None Other Briefly describe the project -- plants used, irrigation changes, etc. ("After" photos must be included with this part of application.) How did you complete your project? Estimated Cost: NOTES: Self Contractor Other SURVEY QUESTIONS The following information will help us evaluate program water savings: (your information will NOT be sold or distributed) Number of Household Occupants Pool: Yes / No Dishwasher Remaining Turf Square Feet Fountain: Yes / No High Efficient No. of Baths Spa/Hot Tub: Yes / No Clothes Washer? No. of Showers Vegetable Garden: Yes / No Tankless Water Wash Cars at Home: Yes / No Heater Are you interested in other types of programs and incentives? Circle those that you may want to participate in. Smart Irrigation Controller (weather-based) Rebates High Efficiency Toilets Other: Efficient Irrigation Equipment Rebates Rain Barrels High Efficiency Washing Machines Gray Water Systems OFFICIAL USE ONLY Processed by: Date Received: Checklist: Final Sq. Ft. Notes: Approved Photos Denied Description Amount to Pay 25% Plant

5 TURF REMOVAL FINAL PROJECT DESCRIPTION Please provide a list of plants (new and remaining) as well as a brief description of your conversion project below. A contractors final plan and description is acceptable. Irrigation Conversion: Contractor installed? Company Cost Self installed? Estimated Cost Planted recommended low-water use plants (describe below)? Removed, cut or capped off sprinkler lines Removed, cut or capped off sprinkler lines Installed low-water volume irrigation Drip Bubblers Other Pressure reduction installed? New irrigation controller installed? Smart (weather-based) installed? Controller model Will you hand water? 2" minimum Mulch applied in open areas? Rock coverage in open areas? No concrete or grout used for walkway installation? Plant List: # New Name # New Name Check if NEW leave or blank if describing existing plants. Use additional sheets for more plants or need to add more description.

6 Residential Turf Removal Program Application Part 2 Rebate Request Submit when your project is complete Please include the following when you submit Part 2 Rebate Request 3 recent color photos of each of the turf removal areas and the final conversion Labels and titles of the photos (please write on the pictures) Enclosed "Final Project Description" Form On the enclosed "Final Project Description" form, please describe what you did to convert your spray irrigation system to low volume system and provide us with a list of the plants, trees, and shrubs remaining or new. Also describe the amount and depth of mulch and/or rock used to cover non-planted areas. Plant list describing the 25% plant material coverage requirement Irrigation conversion description

7 High Desert Turf Removal Program Terms and Conditions PROGRAM UNDERSTANDING This program is sponsored by Golden State Water Company to encourage the removal of live, maintained and irrigated turf and replace it with climate appropriate, low water use landscapes and efficient irrigation systems. There are significant requirements that must be followed to assure successful approval of an eligible project. Please read all of these Terms and Conditions carefully and follow the instructions. Incomplete and non-qualifying applications will be returned. Projects that do not adhere to these guidelines will be rejected for payment. All sites may be subject to pre and post inspection at the discretion of the Program Manager. Funding is limited. This offer is limited and is available on a first-come, first-served basis to eligible participants while funding lasts. This program may terminate at any time and without notice. In order for the rebate to be issued to you, all program requirements must be met, including completion of your project within the timeframe designated in your Authorization to Proceed. Golden State Water Company does not warrant that the removal of turf and replacement by other materials and irrigation systems will lower water usage. Water usage is determined by customer behavior and use. The incentives provided by Golden State Water Company also are not established to cover all of the costs associated with turf removal and new landscape installation and the incentive is likely not going to cover all associated costs. Submitting a signed application to Golden State Water Company shall serve as the customer s agreement to all terms and conditions associated with the program as stated in this document. ELIGIBILITY GUIDELINES Customers must provide a completed application and receive an Authorization to Proceed BEFORE initiating any work on your project. Projects that are underway or already completed prior to receiving the Authorization to Proceed are not eligible. The property must receive water service from GSWC. Applications must be submitted by the property owner ONLY. If the property owner is not the GSWC account holder, the property owner must submit a copy of their tax bill showing ownership. Areas to be converted must have live turf being irrigated with potable water at the time the Authorization to Proceed is issued. All turf removal conversions, including historic sites, are subject to the terms of their local city or county landscape ordinance and must comply with all applicable Federal, State and local laws, as well as applicable CC &Rs and/or HOA restrictions. PROGRAM TERMS Only one Turf Removal rebate per address will be issued. Please apply for the maximum area you plan to convert RESIDENTIAL Residential landscape conversion limits 100 square feet minimum of turf must be removed. Projects less than 100 sq. ft. may qualify if they will completely eliminate turf from a property. A maximum rebate of $3,000 will be paid. Projects more than 3,000 sq, ft will be considered by GSWC on a case-by-case-basis. LARGE LANDSCAPE and COMMERCIAL/INDUSTRIAL/INSTITUTIONAL Commercial/Industrial/Institutional (CII) landscape conversion limits 100 square feet minimum of turf must be removed from property. A maximum rebate of $ $10,000 will be paid. Projects more than 10,000 sq. ft. will be considered by GSWC on a case-by-case basis. Authorizations to Proceed are valid for six months, Projects must be completed and the necessary Part 2 with pictures must be submitted prior to the notice expiring. Rebates may be considered taxable income for rebates of $ or more. GSWC is not responsible for any taxes, penalties or interest that may be imposed in connection with your receipt of any rebate. Check with your tax advisor regarding this requirement. By submitting a signed application, customer agrees to submit to a pre and/or post inspection by Golden State Water Company staff or designated representative in order to confirm the information provided by the customer. The decision to perform a pre or post inspection is at the discretion of the Program Manager. Any deficiencies can result in the application being denied and no rebate issued. Customer is responsible for all costs associated with their turf removal project and new landscape installation. Projects can be completed by the customer or with a contractor. GSWC is only rebating the value of the turf removed based on a successful project that meets all terms and conditions. The converted area must remain in compliance with all program conditions for a period of five (5) years. If this requirement is violated, you may be required to refund all or a portion of the rebate. This requirement to maintain program conditions is not binding on successor owners. Ver _HD T&C Page 1

8 PROJECT REQUIREMENTS Upon completion, the converted area must meet the following requirements. 25% living plant material must remain or be planted in the converted landscape area. Existing trees, shrubs, and plants qualify. Any remaining turf in the proposed areas will be deducted from the final square footage. In-ground spray irrigation systems must be converted to low-volume drip systems per program standards. Irrigation systems must be designed and operated to prevent any water runoff or overspray onto hardscapes and streets. All exposed soil must be covered with mulch or rock. Converted areas must be permeable to air and water. Weed barriers must be permeable. Un-grouted stepping stones and water permeable artificial turf is allowed. Landscapes with exposed soil will not be approved for payment. Non-water permeable materials (such as plastic film and concrete) are not allowed. Concrete walkways and driveways are not allowed. Decomposed granite (DG) walkways that allow runoff into the landscape and not onto other hardscape is allowed. No water features are allowed. No invasive plant species are used. Visit the California Invasive Plant Council at for a list of plants to avoid. PARTICIPATION INSTRUCTIONS Projects that are underway or already completed prior to applying to the program and receiving the Authorization to Proceed are not eligible. Please complete all sections of the application, take the necessary pictures and measurements, and return it, along with a copy of your recent water bill, to: Golden State Water Company Turf Removal Program 1920 West Corporate Way Anaheim, CA Submit no less than three (3) color photos of the areas to be removed showing live turf. Measurements only include areas with turf. Indicate current type of irrigation system. Submit a general description of the conversion plan including plant list and irrigation. A contractor s proposal and drawing is acceptable. pictures and copies of applications can be submitted at Applications with original signature must be submitted by mail. All work performed in association with the project must be completed within the period indicated on your Authorization to Proceed. No extensions will be granted. RELEASE OR CLAIMS AND INDEMNIFICATION Removal of turf and installation of water efficient devices and plants does not guarantee reduced water use and the incentive provided by GSWC is not guaranteed to cover all expenses associated with a customer s project. By participating in the program and accepting the rebates provided, you thereby release GSWC from any and all claims and causes of action that may arise out of your removal of turf from your property and/or the purchase, installation, and/or use of water efficient devices in connection with this Turf Removal Program. Any and all claims or causes of action you may have in connection with any defect or failure of performance of any contracted service or installed product or device provided to you for your project may only be pursued with the contractor you hired or the appropriate manufacturer/distributor. Quality of work and appearance of the converted area are the responsibility of the participant. Further, you agree to indemnify, defend and hold harmless GSWC from all liability and claims of any kind arising out of or related to your removal of turf and purchase, installation, and use of water efficiency devices in connection with the program. CONTACT INFORMATION Water Use Efficiency Staff Toll Free (800) Ver _HD T&C Page 2

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