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STATE OF CALIFORNIA <br />STATE WATER RESOURCES CONTROL BOARD <br />Division of Financial Assistance <br />P. O. Box 944212, Sacramento, CA 94244 -2120 <br />FINANCIAL ASSISTANCE APPLICATION <br />Clean Water State Revolving Fund <br />Water Recycling Funding Program <br />GENERAL INFORMATION PACKAGE <br />I. TYPE OF ASSISTANCE REQUESTED <br />Amount of Assistance Requested: $4,000,000.00 <br />Proposed Security: 0 Wastewater revenues and fund ❑Water revenues and fund ❑ Other: <br />Project Type(s): ® Wastewater ❑ Water Recycling ❑ Estuary ❑ Nonpoint Source <br />11. APPLICANT INFORMATION <br />Applicant Name: City of Santa Ana <br />Street Address:20 Civic Center Plaza <br />City. Santa Ana _ <br />State: CA <br />Zi +4 Code: 92702 -4058 <br />Applicant Type: ❑✓ Public ❑ Indian Tribe Non rofit ❑ Other: Specify <br />CharterCity /County: Iv Yes [D No <br />Mailing Address: 220 S Daisy St <br />City: Santa Ana <br />State: CA <br />Zi +4 Code: 92703 -4334 <br />� <br />Congressional District(s): 46 <br />State Senate Districts): 34 <br />_ <br />State Assembly District(s): 69 <br />County: Orange <br />Federal Tax ID No.: 95-6000785 <br />Data Universal Numbering System DUNS No.: 08- 315 -3247 <br />glonal Water Board where the project will take place: ❑ 1 (North Coast) ❑ 2 (San Francisco Bay) <br />3 (Central Coast) ❑ 4 (Los Angeles) ❑ 5 (Central Valley) ❑ 6 (Lahontan) ❑ 7 (Colorado River) <br />❑✓ 8 (Santa Ana) ❑ 9 (San Diego) <br />Authorized Representative Name, Title: Nabil Saba, Water Resources Manager <br />Phone No.: (714 ) 647 -3378 <br />Email Address: nsaba(ilsanta- ana.org <br />Contact Person Name: Rodolfo Roses <br />Phone No.: 714 647 -3379 <br />Email Address: rrosas @ santa- ana.org _ <br />Local Counsel Name: Sonia Carvalho <br />Phone No.: 714 647 -5203 <br />_ <br />Email Address: scarvalh_o @santa - ana.org <br />_ <br />III. PROJECT INFORMATION AND PROPOSED SCHEDULES <br />Project Description: (Enter a brief description of the project) <br />Reconstruct existing aging sewer lift station to: increase capacity in the sewer collection system and increase energy <br />efficiency through newer electrical components, pumps and motors; reduce long -term safety and traffic impacts by <br />relocating the station from its existing location (In Bristol Street, a major arterial) to a nearby off street location. <br />Pro'ect'fitle: San Lorenzo Sewer Lift Station <br />NPDES Permit or WDR Order No. if applicable): WDR Order No. 2006- 0003 -DWQ, WDID 8SS010602 <br />Current Year Estimated Population Served: City: 335,264 CA DOF Table E -1, 2015); Upstream: 22,650 (7 %) <br />Stale Use Only <br />CWSRF Project 9 <br />Project Manager <br />Date Received <br />Financial Assistance Application Page 1 of 3 General Information Package <br />(Rev. 0312015) <br />EXHIBIT 5 <br />55B -21 <br />