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�, Environmental <br />�Q' Protection <br />Agency <br />H2Ohio Rivers Initiative Chloride Reduction <br />Grant Application <br />Ohio Environmental Protection Agency <br />Division of Surface Water <br />Part 1: Cover Sheet <br />(Project Applicant Information <br />Organization: Village of Mayfield <br />Mailing Address: 6622 Wilson Mills Rd City: Mayfield <br />State: OH Zip+4 44143-2311 County: Cuyahoga <br />Federal Tax <br />Identification #: 346001844 <br />Do you apply salt or other deicers to roads, sidewalks or surface lots throughout your territory? YES <br />ease ensure a person esigna a as a au onzmgo o sign a gran agreementan any <br />General Project Information contracts related to the grant. <br />Project manager Project Manager <br />First Name Scott Last Name Sipos <br />Phone Number <br />(with Area Code) 440-442-5506 <br />Project Manager <br />Email: ssipos@mayfietdvi[lage.com <br />ress: i <br />different from <br />above) 610 SOM Center Rd <br />eld State: OH Zip+4 44143-2311 <br />Obtal Funds <br />Requested: $75,000 <br />Watershed Name USGS 12-digit HUC <br />(12-di it HUC): Griswald Creek Chagrin River Watershed Number Code: OH-041100030402 <br />Yes No <br />This project is described in an approved 9-Element Ohio Nonpoint ( see Below) <br />Implementation Strategy (NPS-IS) or AMDAT strategy? ❑ Not Sure <br />If not described in an approved 9-element NPS-IS, are you preparing or updating an existing <br />NPS-IS? An approved NPS-IS exists; plan can be updated as ne <br />Authorization <br />To the best of my knowledge and belief, all data and information contained in this project application is true, current, and correct. This application <br />package is duly authorized by the following governing body. - <br />Authorized <br />Individual Name: Scott Si <br />Title: Service Director <br />Individual <br />Signature: sOj Date: January 24, 2024 <br />This signature may be submitted with on esignoture on the Adobe PDF copy. Otherwise, this page may be printed, signed, scanned, <br />and submitted along with the full Microsoft Excel file and Adobe file submitted via email to <br />coro.hordesty(@epa.ohio.gov and iohn.mathews(@epo.ohio.gov. Thankyou. <br />if ?Ohio Rivers Chloride Reduction Grant <br />age 1 of 7 12/8/2023 <br />