![](media/image1.png){width="1.0in" height="1.3047244094488188in"}

# FRIMA 2005 {#frima-2005 .FSP-Cover-Head}

# (Fisheries Restoration and Irrigation Mitigation Act)

# Fish Screening or Passage Grant Application {#fish-screening-or-passage-grant-application .FSP-Cover-Head}

![](media/image3.png){width="2.829861111111111in"
height="3.263888888888889in"}

# Economic Incentives for Water Users to Protect Fish {#economic-incentives-for-water-users-to-protect-fish .FSP-Cover-Head}

+-----------------------------------+-----------------------------------+
| ## General Instructio             |                                   |
| ns. See detailed information in a |                                   |
| pplication text. {#general-instru |                                   |
| ctions.-see-detailed-information- |                                   |
| in-application-text. .unnumbered} |                                   |
+-----------------------------------+-----------------------------------+
| **[NOTE]{.underline}: It is       | 7.  **Regulatory Clearance:** The |
| critical that you contact and     |     applicant must obtain all     |
| work with the Regional Field      |     regulatory clearances (ESA,   |
| Coordinator for your area for     |     NEPA, SHPO, DSL, etc.) before |
| proper completion of this         |     USFWS will approve funding.   |
| application.\                     |                                   |
| *See contact information page     | 8.  **Attachments:** Use extra    |
| 16.***                            |     pages for additional          |
|                                   |     documentation (site maps,     |
| 1.  **Application Deadline:       |     photos, drawings, plans,      |
|     [January 15,                  |     etc.) as needed               |
|     2005]{.underline}**           |                                   |
|                                   | 9.  **Signature:** By             |
| 2.  **Eligibility**: The          |     electronically submitting     |
|     screening or passage project  |     your application with a typed |
|     must be associated with a     |     signature, you agree to the   |
|     water diversion and benefit   |     conditions stated in the      |
|     fish species native to the    |     application. If submitting in |
|     project area.                 |     hard copy format, type or     |
|                                   |     print clearly in dark ink and |
| 3.  **Matching Funds:** The       |     sign your application in ink. |
|     applicant must identify at    |                                   |
|     least 35% non-federal         | 10. **Social Security/Tax ID      |
|     matching funds.               |     Number:** To qualify for      |
|                                   |     reimbursement or Oregon state |
| 4.  **Federal Funds:** Federal    |     tax credit, a Social Security |
|     funds other than FRIMA cannot |     or Tax ID number must be      |
|     be applied to the same        |     supplied.                     |
|     project.                      |                                   |
|                                   | 11. **Submission:** Submit        |
| 5.  **Ranking Criteria:**         |     Application materials to the  |
|     Successful candidates will    |     ODFW Regional Field           |
|     meet project eligibility      |     Coordinator for your area.    |
|     criteria as well as           |                                   |
|     demonstrate some of the       |     **\*\*\*\*\*\*\*\*            |
|     following: benefit to species | \*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\ |
|     in special conservation       | *\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*** |
|     status; partner involvement   |                                   |
|     and contribution; additional  | ## Please keep a c                |
|     biological benefits or water  | opy of your application materials |
|     use efficiencies; or          | . {#please-keep-a-copy-of-your-ap |
|     sponsorship by local          | plication-materials. .unnumbered} |
|     government entity associated  |                                   |
|     with irrigation water         |                                   |
|     diversions.                   |                                   |
|                                   |                                   |
| 6.  **Partners:** The application |                                   |
|     must include at least one     |                                   |
|     local, state, tribal or       |                                   |
|     federal government sponsor or |                                   |
|     co-applicant. Cooperation     |                                   |
|     with other affected           |                                   |
|     non-government partners is    |                                   |
|     encouraged.                   |                                   |
+-----------------------------------+-----------------------------------+
| ## Application Process {          |                                   |
| #application-process .unnumbered} |                                   |
+-----------------------------------+-----------------------------------+
| 1.  A Ranking Committee reviews   | 15. ODFW then enters into grant   |
|     all applications and makes    |     agreements between ODFW and   |
|     recommendations to ODFW.      |     the applicants of the         |
|                                   |     approved projects.            |
| ```{=html}                        |                                   |
| <!-- -->                          | 16. Construction of project       |
| ```                               |     begins.                       |
| 12. From the recommendations,     |                                   |
|     ODFW determines a list of     | 17. Once construction is          |
|     projects to be forwarded to   |     complete, the applicant       |
|     USFWS for approval.           |     submits invoice documentation |
|                                   |     to begin the reimbursement    |
| 13. USFWS approves projects from  |     process.                      |
|     the ODFW list. USFWS approves |                                   |
|     funding once the applicant    | 18. ODFW approves invoices and    |
|     supplies regulatory           |     reimburses applicant.         |
|     clearances.                   |                                   |
|                                   |                                   |
| 14. ODFW enters into grant        |                                   |
|     agreements between ODFW and   |                                   |
|     USFWS for the approved        |                                   |
|     projects.                     |                                   |
+-----------------------------------+-----------------------------------+

NOTE: This document is electronically protected to allow the form fields
to work. If you need to unlock the document, the password is "FISH".
Some software versions may cause you to lose existing keyed data when
un-protecting a document.

+-----------------------------------------------------------------------+
| ###### ![](media/image4.png){width="0.9                               |
| 902777777777778in" height="1.1965277777777779in"}FRIMA 2005 -- OREGON |
|                                                                       |
| ## Fisheries Restoration and Irrigation Mitigation Program            |
|                                                                       |
| # Fish Screening or Passage Cost Share Grant Application              |
+-----------------------------------------------------------------------+

+-----------------------------------------------------------------------+
| ## General Information {#general-information .unnumbered}             |
+-----------------------------------------------------------------------+

## [NOTE]{.underline}: It is critical that you contact and work with the Regional Field Coordinator for your area for proper completion of this application. *See contact information page 16.*

## Overview

The Fisheries Restoration and Irrigation Mitigation Act of 2000 (FRIMA)
(PL 106-502) is a federal fish screening and passage partnership program
in Idaho, Oregon, Washington and western Montana that is administered by
the U.S. Fish and Wildlife Service (USFWS). The purpose of this program
is to match federal funds with local, state, and tribal programs to
increase fish survival, reduce entrainment in existing water
distribution systems, and increase access to productive fish habitat.

## Eligibility Criteria

***(See detailed eligibility criteria page**
[5](#project-eligibility-criteria)**.)***

To be eligible for consideration under this program, a proposed fish
screening or passage project must be associated with a water diversion
and benefit fish species native to the project area. The project
proposal may include other modifications to the water diversion that are
directly associated with screening or passage improvements.

Project sponsors must identify at least 35% non-federal matching funds
for the design and construction of an eligible project. Matching funds
may include in-kind contributions such as easements, materials,
equipment, or labor. Applicants must assume responsibility for operation
and maintenance costs of the project as outlined in the grant conditions
***(page 12)*.**

This is a partnership program and all applications must include a local,
state, tribal or federal government sponsor or co-applicant. Some
special provisions apply for projects on federal lands and for proposals
involving tribal lands and governments. This is also a voluntary program
and must include the involvement and approval of the project operator
and affected landowners.

All projects must meet applicable state and federal regulatory
requirements and must not involve requests for funding in lieu of
already existing federal funding commitments. Applicants are responsible
for obtaining all regulatory clearances including Endangered Species Act
(ESA), National Environmental Policy Act (NEPA), the State Historical
Preservation Office (SHPO) and all necessary state, county and local
permits. Projects will not receive final approval until all regulatory
clearances are granted.

## Ranking Criteria

***(See detailed ranking criteria page 6)***.

A team of local, state, tribal, and federal reviewers will rank Oregon
project applications and recommend projects for funding under this
program. In making their recommendations, the review team will determine
if the application clearly documents that the project meets program
eligibility requirements. The review team will also consider the
magnitude of benefits anticipated to native fish species including
improved survival and habitat access, cost effectiveness in achieving
those benefits, and likelihood of success of the project as proposed.
Additional consideration will be given to projects that benefit species
in special conservation status such as federally endangered species and
projects that are elements of conservation or recovery plans.
Applications will also be evaluated on the degree of partner involvement
and contribution, thoroughness of coordination with other affected or
interested parties, opportunities for additional biological benefits or
water use efficiencies, and the status of completion of applicable
regulatory reviews. Preference will be given to projects sponsored by
local governments and to fish passage and screening associated with
irrigation water diversions

## Project Types Available for Cost Share Funding

**Screening:** The cost share program covers both pump and gravity-type
water diversions.

Project application includes commitment by one or more project operators
or sponsors to assume all operation and maintenance costs for the life
of the project.

**Passage:** A passage project is defined as a single fishway at a
specific site. Dam removal (in lieu of a fishway) will also be
considered for cost share. Culverts and tide gates are not eligible for
funding under this program.

The owner or occupant of the dam or artificial obstruction is
responsible for all maintenance including repair of the fishway(s).

## Partnership

ODFW has existing expertise regarding fish screen and fishway design
requirements as well as fabrication and installation. USFWS anticipates
that most screening and passage projects will be designed and
constructed in partnership with existing state and local government
programs. "Local government" includes county, municipal government, or
local service district such as an irrigation or soil and water
conservation district. You are encouraged to work closely with state and
local government points of contact in the planning of your proposed fish
screening or passage project. Projects on tribal lands require close
coordination with or sponsorship by tribal governments.

## Tax Credit

In addition to the cost share program, there is a state income tax
credit allowed for both fish screening and fish passage devices. The tax
credit allowed for a fish screen or passage device is 50% of the water
user's net certified costs, not to exceed \$5,000 per device. To obtain
a tax credit, the applicant must request a preliminary certification
from ODFW prior to construction \[ORS 315.138\] ***(see grant
conditions, page 12*)**.

## Application Form and Submission

*(See Oregon and federal points of contact page 16.)*

Complete this Oregon application package to be considered for funding
under this partnership program. The package includes a FRIMA
Supplemental Information Sheet ***(page 7)*** and Fish Screening and
Passage Program Cost Share Grant Application ***(page 9)***.

Attached is a list of both Oregon and federal points of contact who can
advise you regarding project eligibility and the application process.

Submit the completed application with supporting materials (map to site,
photos, drawings, plans, hydrologic or hydraulic analyses) to the ODFW
Field Coordinator for your area.

Submit applications for projects on **federal lands** directly to Jerry
Van Meter, U.S. Fish and Wildlife Service. Federal Coordinator***.***

To receive an electronic version of this form, contact the ODFW Regional
Field Coordinator for your area.

## Application Due Date

To be considered for 2005 funding, please submit your application no
later than **January 15, 2005**.

+-----------------------------------------------------------------------+
| ## Project Eligibility Criteria                                       |
|                                                                       |
| ## Fish Restoration and Irrigation Mitigation Prog                    |
| ram {#fish-restoration-and-irrigation-mitigation-program .unnumbered} |
+-----------------------------------------------------------------------+

**1.** Project includes design, construction, and installation of fish
screens, fish passage devices and other related features[^1] which are
associated with an irrigation or other water diversion or is a project
inventory proposal from a lead state agency, typically a state fish and
wildlife agency or federally recognized tribe in partnership with a
state.

**2.** Project is located in the states of Idaho, Oregon, Washington, or
in Montana west of the continental divide.

**3.** Project intent is to reduce fish mortality, reduce entrainment of
fish in water distribution systems, or increase subsequent survival and
reproductive success of fish species native to and present in the
project area.

**4.** Project application includes commitment by one or more project
operators or sponsors to assume all operation and maintenance costs for
the life of the project.

**5.** For most projects, one or more applicants must be regional
government entities such as a regional, county, municipal, or service
district. Projects on tribal lands are to be sponsored or co-sponsored
by tribal governments. Projects at federally owned facilities or on
federal lands may be sponsored by the owning agency in partnership with
a local government co-applicant.

**6.** Project application demonstrates commitment of at least 35% of
total project cost from funding sources other than FRIMA. In the case of
projects not under federal ownership, this cost share must be from a
non-federal funding source. Applicant cost share may include in-kind
costs such as labor, equipment, fill material, material disposal areas,
lands, easements, right-of-ways, relocations and other such project
requirements.

**7.** Project application states that federal funding is not being
received from any other source for the same specific project purpose and
that the action is not for compliance with conditions of an existing
Federal Energy Regulatory Commission (FERC) license.

**8.** Project application demonstrates prior coordination with
applicable state fish screening entity, normally a state fish and
wildlife agency, and appropriate USFWS field office.

**9.** Project application demonstrates coordination underway or
completed for all regulatory review or approval actions with state and
federal resource managers necessary for project construction or
installation.

**10**. Project application demonstrates coordination with and documents
approval by project owner/operator and, if necessary, by adjacent
landowner(s) for required construction access.

+-----------------------------------------------------------------------+
| ## Project Ranking Criteria                                           |
|                                                                       |
| ## Fish Restoration and Irrigation Mitigation Progra                  |
| m {#fish-restoration-and-irrigation-mitigation-program-1 .unnumbered} |
+-----------------------------------------------------------------------+

**1.** Project increases survival and reproductive success of fish
species native to the project area.

**2.** Project increases area of productive habitat accessible or
utilized by native fish species present in the project area. Consider
benefits to multiple species or other watershed productivity
implications.

**3.** Project benefits fish species in depleted or special conservation
status, including Endangered Species Act (ESA) listings.

**4.** Project is a measure identified in specific fish management,
conservation, or recovery plan.

**5.** Proposed project techniques and methodology have a high degree of
likelihood of achieving proposed results under the full range of
normally experienced operating conditions.

**6.** Project demonstrates cost effectiveness in achieving project
purposes compared to similar projects and alternative means of achieving
the same proposed result. Preference is given to projects under \$5
million in total cost.

**7.** Project is associated with an irrigation water diversion or point
of irrigation water withdrawal.

**8.** Project provides additional opportunities for biological benefits
or saving of water for other instream or agricultural uses.

**9.** Project proposal makes maximum effective use of program funds by
involving other local and regional funding sources in the proposed
project and in related restoration activities.

**10.** Project applicant or participating co-sponsor is a locally based
government entity such as a county, municipal government, or local
service district such as an irrigation or soil and water conservation
district.

**11.** Project application demonstrates thorough coordination with
appropriate federal, state, local, and private entities including local
landowners.

**12.** Project can be completed and yield proposed benefits in a timely
manner. Assess whether project application identifies and demonstrates
approval or substantial progress toward approval of all regulatory
requirements required for construction or installation.

+-----------------------------------------------------------------------+
| ## Fisheries Restoration and Irrigat                                  |
| ion Mitigation Act (FRIMA) Application Supplemental Information Sheet |
|                                                                       |
| This information supplements the Oregon Fish Screening and Passage    |
| Cost Share Grant Application ***(page 9)***.                          |
|                                                                       |
| Please submit this sheet with the application to the designated point |
| of contact ***(page 16)***.\                                          |
| Your responses may refer to information included in the application   |
| or other materials attached to the application. To facilitate review  |
| of your application, please be sure that the project description and  |
| attachments clearly describe your proposed actions, anticipated       |
| benefits, and estimated costs. **Attach additional pages as needed.** |
+-----------------------------------------------------------------------+

## Eligibility 

(Where appropriate, check Yes or No.)

1.  Do you verify that federal funding is not being received from any
    other source for this same specific project purpose and that this
    action is not for the purpose of compliance with a FERC license
    requirement? ***(A "No" response means project is ineligible.)***

Yes No

2.  Does the project screen a water diversion to increase survival and
    reduce entrainment of fish species native to the project area?

Yes No

3.  Does the project provide or improve access to aquatic habitat for
    fish species native to the project area?

> **Yes** **No**

4.  What is the purpose(s) of the associated water diversion?

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

5.  List the applicant(s) and additional sponsors of the proposed
    project. Identify which of the applicants or sponsors are local
    government, including irrigation or soil and water conservation
    districts.

6.  Indicate the party or parties accepting responsibility for operation
    and maintenance costs of screening and passage facilities. Attach a
    letter documenting this commitment.

7.  Identify the cost share commitment of project applicants or
    cosponsors, which must be at least 35% of project costs and must be
    non-federal funds unless project is on federal land. Attach a letter
    documenting this commitment including determination of value of any
    in-kind contributions.

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

8.  Identify contacts that have been made with U. S. Fish and Wildlife
    Service, Oregon Department of Fish and Wildlife, and/or any tribal
    fish and wildlife office concerning this project. Attach
    communications if appropriate.

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

9.  Identify regulatory reviews or approvals that will be needed prior
    to the construction or installation of this project and indicate
    steps already completed to accomplish this.

10. Is the applicant or co-applicant the project operator, the owner of
    lands where the project will be sited, and the owner of lands
    required for construction access? If not, attach documentation
    indicating coordination and concurrence by the landowner.

> **Yes** **No**

## Additional project information

**Attach supplemental or explanatory information where appropriate.**

11. Identify any fish species native to the project area that will
    benefit from this project. Indicate if any of those species are
    listed on the federal Endangered Species List or have other special
    conservation status.

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

12. Estimate the increase in survival to native fish species in
    percentage and/or number of fish attributable to the proposed
    project. Identify the basis for your estimate.

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

13. Estimate the amount and type of additional fish habitat that will be
    accessed or more completely utilized as a result of this project.

14. Indicate why you believe that the proposal will be both successful
    and cost effective in achieving the benefits indicated in questions
    11-13.

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

15. Will installation of the project provide other indirect biological
    benefits or increased water use efficiency?

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

16. Identify the time period that project design, pre-construction
    approvals, and project construction can be completed. Indicate the
    basis of your estimate.

  -----------------------------------------------------------------------
       

  -----------------------------------------------------------------------

<table style="width:100%;">
<colgroup>
<col style="width: 12%" />
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</colgroup>
<tbody>
<tr class="odd">
<td colspan="33"><h6 id="oregon-department-of-fish-and-wildlife"><img
src="media/image4.png" style="width:0.99028in;height:1.19653in" />Oregon
department of fish and wildlife</h6>
<h2
id="fish-screening-and-passage-program-cost-share-grant-application">Fish
Screening and Passage Program<br />
Cost Share Grant Application</h2></td>
<td></td>
</tr>
<tr class="even">
<td colspan="33"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="33"><h2 id="applicant-information">Applicant
Information</h2>
<p>Please type or print legibly in dark ink.</p></td>
<td></td>
</tr>
<tr class="even">
<td colspan="33"></td>
<td></td>
</tr>
<tr class="odd">
<td>Project #:</td>
<td colspan="8">     </td>
<td colspan="7">Project Title</td>
<td colspan="16">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="6">Date Application Submitted:</td>
<td colspan="10">     </td>
<td colspan="16">(Project Number and Title to be assigned by ODFW)</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="6"></td>
<td colspan="10"></td>
<td colspan="16"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="4">Applicant Name:</td>
<td colspan="27">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4">Co-applicant Name:</td>
<td colspan="27">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="27"><em>(If applicable.)</em></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4">Business Name:</td>
<td colspan="27">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4">Mailing Address:</td>
<td colspan="27">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="27">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="2">Work Phone:</td>
<td colspan="3">(     )</td>
<td colspan="9">     </td>
<td colspan="5">Ext:</td>
<td colspan="8">     </td>
<td colspan="4"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Home Phone:</td>
<td colspan="3">(     )</td>
<td colspan="9">     </td>
<td colspan="8">Other Phone:</td>
<td colspan="2">(     )</td>
<td colspan="7">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="2">Fax:</td>
<td colspan="3">(     )</td>
<td colspan="9">     </td>
<td colspan="6">E-mail:</td>
<td colspan="11">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="7">Is applicant an Oregon taxpayer?</td>
<td>Yes</td>
<td colspan="3"></td>
<td colspan="2">No</td>
<td colspan="4"></td>
<td colspan="8">Federal Tax ID or SS #:</td>
<td colspan="5">     </td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="31"><em><strong>(Please Note: To qualify for reimbursement
or tax credit, either a TID or SS# must be supplied)</strong></em></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="10">Contact Person (if different than applicant):</td>
<td colspan="21">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="5">Contact Person’s Title:</td>
<td colspan="26">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="5">Mailing Address:</td>
<td colspan="26">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="5"></td>
<td colspan="26">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Work Phone:</td>
<td colspan="3">(     )</td>
<td colspan="7">     </td>
<td colspan="3">Ext:</td>
<td colspan="12">     </td>
<td colspan="4"></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="2">Home Phone:</td>
<td colspan="3">(     )</td>
<td colspan="7">     </td>
<td colspan="9">Other Phone:</td>
<td colspan="3">(     )</td>
<td colspan="7">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Fax:</td>
<td colspan="3">(     )</td>
<td colspan="7">     </td>
<td colspan="6">E-mail:</td>
<td colspan="13">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="9"></td>
<td colspan="10"></td>
<td colspan="9"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="3">Water Permit #:</td>
<td colspan="9">     </td>
<td colspan="10">Water Certificate #</td>
<td colspan="9">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="3">Permit Date:</td>
<td colspan="9">     </td>
<td colspan="10">Certificate Date:</td>
<td colspan="9">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="3">Permit Character:</td>
<td colspan="9">     </td>
<td colspan="10">Certificate Type:</td>
<td colspan="9">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="12"></td>
<td colspan="11">Is this a hydropower project?</td>
<td colspan="3">Yes</td>
<td colspan="2"></td>
<td>No</td>
<td colspan="2"></td>
<td colspan="3"></td>
</tr>
</tbody>
</table>

<table style="width:100%;">
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<col style="width: 1%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 10%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 19%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="15"><h2 id="project-information" class="unnumbered">Project
Information</h2></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="4"></td>
<td></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td colspan="2">Project #:</td>
<td colspan="4">     </td>
<td>Project Title:</td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="10"><strong>TYPE:</strong> Specify type of project, i.e.
fish ladder, pump, belt screen, etc.</td>
<td colspan="5"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="2">Passage</td>
<td colspan="5">     </td>
<td colspan="6">Stream miles made accessible</td>
<td>      miles</td>
</tr>
<tr class="even">
<td colspan="8"></td>
<td colspan="7"><em>Passage only, additional miles only</em></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="2">Screening</td>
<td colspan="5">     </td>
<td colspan="6">Flow Rate in cfs (Screens only)</td>
<td>      cfs</td>
</tr>
<tr class="even">
<td colspan="8"></td>
<td colspan="7"><em>cfs = “cubic feet per second." 1 cfs = 449 gallons
per minute</em></td>
</tr>
<tr class="odd">
<td colspan="4">Water Use Purpose(s):</td>
<td colspan="4">     </td>
<td colspan="3">Water Use Months:</td>
<td colspan="4">     </td>
</tr>
<tr class="even">
<td colspan="15"></td>
</tr>
<tr class="odd">
<td colspan="15"><strong>DESCRIPTION:</strong> Describe project purpose,
history or background, techniques to be used, major project features,
construction timing, etc. Use additional page(s) if necessary. Attach
site map(s), photos, drawings and/or plans.</td>
</tr>
<tr class="even">
<td colspan="15">     </td>
</tr>
<tr class="odd">
<td colspan="5"><strong>LOCATION:</strong> County</td>
<td colspan="10">     </td>
</tr>
<tr class="even">
<td colspan="5">Watershed Council Area:</td>
<td colspan="4">     </td>
<td colspan="3">Tax Lot: <em>(optional)</em></td>
<td colspan="3">     </td>
</tr>
<tr class="odd">
<td colspan="5">House District:</td>
<td colspan="4">     </td>
<td colspan="3">Senate District:</td>
<td colspan="3">     </td>
</tr>
<tr class="even">
<td colspan="5">Stream Name:</td>
<td colspan="4">     </td>
<td colspan="3">Tributary to:</td>
<td colspan="3">     </td>
</tr>
<tr class="odd">
<td colspan="5">*Latitude:</td>
<td colspan="4">     </td>
<td colspan="3">*Longitude:</td>
<td colspan="3">     </td>
</tr>
<tr class="even">
<td colspan="15"><em>(*Must be in decimal degrees, e.g. 44.83107ºN,
120.03057ºW. ODFW staff will survey site and supply these figures if
needed.)</em></td>
</tr>
<tr class="odd">
<td colspan="13"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="13"><strong>CONTRIBUTORS</strong></td>
<td colspan="2"><strong>$ Amount</strong></td>
</tr>
<tr class="odd">
<td colspan="13"><sup>1</sup> USFWS FRIMA funds requested</td>
<td colspan="2">     </td>
</tr>
<tr class="even">
<td colspan="13"><sup>2</sup> Applicant</td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="13"><sup>2, 3</sup> Partner Contributions (list names of
project partners):</td>
<td colspan="2"><mark></mark></td>
</tr>
<tr class="even">
<td colspan="13">     </td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="13">     </td>
<td colspan="2">     </td>
</tr>
<tr class="even">
<td colspan="13">     </td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="13"><strong>TOTAL ESTIMATED COST:</strong></td>
<td colspan="2"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="15"><p>NOTES:</p>
<p><sup>1</sup> FRIMA funds requested may not exceed 65% of total
cost.</p>
<p><sup>2</sup> FRIMA non-federal contributions must total at least 35%
of total project cost.</p>
<p><sup>3</sup> List names of project partner organizations and amount
of their contribution.</p></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 11%" />
<col style="width: 17%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 15%" />
<col style="width: 0%" />
<col style="width: 4%" />
<col style="width: 19%" />
<col style="width: 4%" />
<col style="width: 19%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><h2 id="project-cost-estimate-sheet">Project Cost
Estimate Sheet</h2>
<p>Provide as much detail as possible.</p></td>
</tr>
<tr class="even">
<td></td>
<td colspan="3"></td>
<td></td>
<td colspan="5"></td>
</tr>
<tr class="odd">
<td>Project #:</td>
<td colspan="3">     </td>
<td>Project Title:</td>
<td colspan="5">     </td>
</tr>
<tr class="even">
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="2">CATEGORY</td>
<td></td>
<td colspan="3">$ FRIMA FUNDS</td>
<td></td>
<td>$ OTHER FUNDS</td>
<td></td>
<td>$ TOTAL COST</td>
</tr>
<tr class="even">
<td colspan="10">Administration – Include personnel benefits in
cost.</td>
</tr>
<tr class="odd">
<td colspan="2">Personnel <strong>Total</strong></td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="10">Project Labor – Include personnel benefits in cost.
Include in-kind labor in <em>“<u>Other Funds</u>”</em> column.</td>
</tr>
<tr class="even">
<td colspan="2">Personnel <strong>Total</strong></td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="10">Construction Materials – Provide amounts and cost per
unit.</td>
</tr>
<tr class="even">
<td colspan="2">Components</td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">Concrete</td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="2">Paint</td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">Other (describe):</td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="10">Supplies</td>
</tr>
<tr class="even">
<td colspan="2">Transportation</td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">Fuels</td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="2">Equipment Rental</td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">Other (describe):</td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="10">Contract Services – Describe and attach subcontractor
estimates including design/engineering.</td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="10">Equipment – Use for individual pieces of equipment
costing over $100.00. Be specific.</td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td></td>
<td colspan="3">     </td>
<td></td>
<td>     </td>
<td></td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="2">TOTAL COSTS</td>
<td></td>
<td colspan="3"><strong>     </strong></td>
<td></td>
<td><strong>     </strong></td>
<td></td>
<td><strong>     </strong></td>
</tr>
</tbody>
</table>

+-------+----------------+---------+----------------------------------+
| #     |                |         |                                  |
| # Gra |                |         |                                  |
| nt Co |                |         |                                  |
| nditi |                |         |                                  |
| ons { |                |         |                                  |
| #gran |                |         |                                  |
| t-con |                |         |                                  |
| ditio |                |         |                                  |
| ns .u |                |         |                                  |
| nnumb |                |         |                                  |
| ered} |                |         |                                  |
+-------+----------------+---------+----------------------------------+
|       |                |         |                                  |
+-------+----------------+---------+----------------------------------+
| Pr    |                | Project |                                  |
| oject |                | Title:  |                                  |
| #:    |                |         |                                  |
+-------+----------------+---------+----------------------------------+

-   To receive the State income tax credit in addition to the cost
    share, the cost share grantee (applicant) must submit fish screening
    and passage project plans and specifications to ODFW, as well as
    request and receive a preliminary certification from ODFW prior to
    construction. After construction is complete, an on-site inspection
    by Department personnel and verification of the net certified cost
    of the installation will be conducted. When the construction is
    approved, a final certificate will be issued \[ORS 315.138\]

-   Grant monies shall be disbursed upon completion of the project after
    costs have been submitted to ODFW. Partial payments may be allowed
    if provided for in the grant agreement. The applicant shall maintain
    accounting records pertaining to this agreement according to
    generally accepted accounting principles and shall make all relevant
    records, documents and reports available to ODFW for the purpose of
    audit examination if requested by the Department.

-   ODFW shall have the right of ingress and egress to and from the
    project areas, doing no unnecessary injury to the property of the
    landowner, for the purpose of designing or inspecting said projects
    and/or determining the adequacy of construction and compliance with
    project plans and provision of the grant agreement.

-   Fish screening or by-pass device maintenance: Grantee is responsible
    for commitment by one or more project operators or sponsors to
    assume all operation and maintenance costs for the life of the
    project.

-   Fish passage project maintenance: Grantee is responsible for all
    fishway repair and maintenance to keep it free from obstruction to
    the passage of fish at all times \[ORS 498.351; ORS 509.610\].

-   Applicant is responsible for coordinating access for construction
    with the landowner.

  ------------------------------------------ -- --------------------------
  *[Applicant signature below indicates         
  acceptance of the above-listed grant          
  conditions.]{.underline}*                     

                                                     

  Name (Typed signature acceptable when         Date
  completed electronically.)                    

                                                

  Title                                         
  ------------------------------------------ -- --------------------------

+-----------------------------------------------------------------------+
| ## Definitions {#definitions .unnumbered}                             |
+-----------------------------------------------------------------------+

  --------------- -------------------------------------------------------
  By-pass Device: Any pipe, flume, open channel or other means of
                  conveyance that transports fish back to the body of
                  water from which the fish were diverted.

                  

  cfs:            A water flow measurement unit. One cfs (cubic feet per
                  second) = 449 gallons per minute.

                  

  Fishway:        A device providing adequate upstream and downstream
                  passage for fish at dams and artificial obstructions.

                  

  Fish Screen:    A screen, bar, rack or other barrier, including related
                  improvements necessary to ensure its effective
                  operation, to provide adequate protection for fish
                  populations present at a water diversion.

                  

  Net certified   The actual documented cost of design, construction and
  cost of         installation of fish protection device as certified by
  installation:   the Department.
  --------------- -------------------------------------------------------

###### 

+-----------------------------------------------------------------------+
| ##                                                                    |
|                                                                       |
| ## Submit your completed application to the ODFW Regio                |
| nal Field Coordinator for your area. See contact information page 16. |
|                                                                       |
| ###### Please Keep A Copy of This Application for Your Records        |
+-----------------------------------------------------------------------+

<table style="width:100%;">
<colgroup>
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 0%" />
<col style="width: 1%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 9%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 1%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 0%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="40"><h2 id="odfw-use-only----project-information">ODFW Use
Only -- Project Information</h2>
<p>Please type or print legibly in dark ink.</p></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="10"></td>
<td colspan="8"></td>
<td colspan="19"></td>
</tr>
<tr class="odd">
<td colspan="3">Project #:</td>
<td colspan="9">     </td>
<td colspan="8">Project Title:</td>
<td colspan="20">     </td>
</tr>
<tr class="even">
<td colspan="40"></td>
</tr>
<tr class="odd">
<td colspan="40">This section to be completed by the ODFW District
Biologist.</td>
</tr>
<tr class="even">
<td colspan="5">ODFW District:</td>
<td colspan="10">     </td>
<td colspan="7">District Biologist:</td>
<td colspan="10">     </td>
<td colspan="2">Date:</td>
<td colspan="3">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="40"></td>
</tr>
<tr class="even">
<td colspan="4">Fish Species:</td>
<td colspan="10">     </td>
<td colspan="5">Fish Run:</td>
<td colspan="6">     </td>
<td colspan="6">Fish Status:</td>
<td colspan="7">     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="4">Fish Species:</td>
<td colspan="10">     </td>
<td colspan="5">Fish Run:</td>
<td colspan="6">     </td>
<td colspan="6">Fish Status:</td>
<td colspan="7">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="4">Fish Species:</td>
<td colspan="10">     </td>
<td colspan="5">Fish Run:</td>
<td colspan="6">     </td>
<td colspan="6">Fish Status:</td>
<td colspan="7">     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="4">Fish Species:</td>
<td colspan="10">     </td>
<td colspan="5">Fish Run:</td>
<td colspan="6">     </td>
<td colspan="6">Fish Status:</td>
<td colspan="7">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="6">Fish Migration:</td>
<td colspan="2">Yes</td>
<td colspan="2"></td>
<td colspan="6">No</td>
<td></td>
<td colspan="7">Fish Numbers:</td>
<td colspan="3">High</td>
<td colspan="3"></td>
<td colspan="3">Med</td>
<td colspan="2"></td>
<td>Low</td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="6"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="6"></td>
<td></td>
<td colspan="7">Basin Priority:</td>
<td colspan="3">High</td>
<td colspan="3"></td>
<td colspan="3">Med</td>
<td colspan="2"></td>
<td>Low</td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="6"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="6"></td>
<td></td>
<td colspan="7">Habitat Quality:</td>
<td colspan="3">High</td>
<td colspan="3"></td>
<td colspan="3">Med</td>
<td colspan="2"></td>
<td>Low</td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="40"><p><strong>District Biologist
Comments/Recommendation:</strong></p>
<p>     </p></td>
</tr>
<tr class="even">
<td colspan="40">This section to be completed by the ODFW Regional Field
Coordinator.</td>
</tr>
<tr class="odd">
<td colspan="7">Diversion Size (cfs):</td>
<td colspan="4">      cfs</td>
<td colspan="18">Diversion Flow Relative to Stream Flow (%):</td>
<td colspan="8">      %</td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="7">Priority Points</td>
<td colspan="4">     </td>
<td colspan="18">Diversions Screened in Stream (%):</td>
<td colspan="8">      %</td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="40"></td>
</tr>
<tr class="even">
<td colspan="40"><p><strong>Field Coordinator
Comments/Recommendation:</strong></p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="40"><p><strong>State Fish Screening/Passage Coordinator
Comments/Recommendation:</strong></p>
<p>     </p></td>
</tr>
<tr class="even">
<td colspan="40"><p><strong>Hydropower Program Leader
Comments/Recommendation (if hydroelectric-related):</strong></p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="40"></td>
</tr>
<tr class="even">
<td colspan="2">Approved</td>
<td colspan="5"></td>
<td colspan="2">Rejected</td>
<td colspan="2"></td>
<td colspan="7"></td>
<td colspan="10">Maximum Contribution:</td>
<td colspan="9">     </td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="22">     </td>
<td colspan="3"></td>
<td colspan="11">     </td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="22">Fish Screening &amp; Passage Program Manager</td>
<td colspan="3"></td>
<td colspan="14">Date</td>
</tr>
<tr class="odd">
<td colspan="40"></td>
</tr>
</tbody>
</table>

<table style="width:100%;">
<colgroup>
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 24%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 0%" />
<col style="width: 13%" />
<col style="width: 3%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 19%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 0%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="20"><h2 id="odfw-use-only----certification">ODFW Use Only
-- Certification</h2>
<p>Please type or print legibly in dark ink.</p></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="4"></td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="3">Project #:</td>
<td colspan="2">     </td>
<td colspan="4">Project Title:</td>
<td colspan="11">     </td>
</tr>
<tr class="even">
<td colspan="20"><h6 id="section-2"></h6></td>
</tr>
<tr class="odd">
<td colspan="20"><h6 id="preliminary-certification-date">Preliminary
Certification Date</h6></td>
</tr>
<tr class="even">
<td></td>
<td colspan="12">Cost Share Grant Application received by ODFW Field
Coordinator:</td>
<td colspan="2"></td>
<td colspan="2">     </td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="12">Preliminary inspection of project:</td>
<td colspan="2"></td>
<td colspan="2">     </td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td>By:</td>
<td colspan="12">     </td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="12">(Field Coordinator)</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td colspan="12"><strong>Preliminary Certificate hereby ISSUED</strong>
<strong>or DENIED</strong> </td>
<td colspan="2"></td>
<td colspan="2">     </td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td>By:</td>
<td colspan="12">     </td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td colspan="12">(State Coordinator).</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="12">Applicant notified that Preliminary Certificate
issued:</td>
<td colspan="2"></td>
<td colspan="2">     </td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td>By:</td>
<td colspan="12">     </td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="12">(State Coordinator)</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="18"><h6 id="final-certification-date">Final Certification
Date</h6></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="11">Applicant request for final inspection received by
ODFW:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="11">Project construction complete:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="11">Final inspection of construction and installation:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>By:</td>
<td colspan="11"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="11">(Engineer, Field Coordinator, or State
Coordinator)</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="15"><p>Project is approved: YES NO </p>
<p><strong>If project is not approved, state reason
why:</strong></p></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="5"><strong>FINAL CERTIFICATE</strong> <em>hereby</em>
<strong>ISSUED</strong> <em>to</em>:</td>
<td></td>
<td colspan="9"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="5"></td>
<td></td>
<td colspan="9">(Applicant/Water User)</td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="15"><em>From the Oregon Department of Fish and Wildlife
this day of</em></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="9"></td>
<td></td>
<td colspan="5"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>By:</td>
<td colspan="9"></td>
<td></td>
<td colspan="5" rowspan="3"><p>Net certified cost of installation:</p>
<p>$</p></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="9">(State Coordinator)</td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="9"></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td></td>
<td colspan="9">(Fish Screening &amp; Passage Program Accountant)</td>
<td></td>
<td colspan="5"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-------------------+---+---+-----+--------------------+------------------+
| ######            |   |   |     |                    |                  |
|  ![](media/image4 |   |   |     |                    |                  |
| .png){width="0.62 |   |   |     |                    |                  |
| 01388888888889in" |   |   |     |                    |                  |
|  height="0.749305 |   |   |     |                    |                  |
| 5555555556in"}FRI |   |   |     |                    |                  |
| MA 2005 -- OREGON |   |   |     |                    |                  |
|                   |   |   |     |                    |                  |
| # Fi              |   |   |     |                    |                  |
| sh Screening or P |   |   |     |                    |                  |
| assage Program Or |   |   |     |                    |                  |
| egon and Federal  |   |   |     |                    |                  |
| Points of Contact |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| ## USFWS Fed      |   |   |     |                    | ##               |
| eral Coordinators |   |   |     |                    | Watershed Basin  |
|                   |   |   |     |                    | Territories for  |
|                   |   |   |     |                    | ODFW Regional Fi |
|                   |   |   |     |                    | eld Coordinators |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | **Bob Hair**     |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 1 North Coast    |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 2 Willamette     |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 3 Sandy          |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 4 Hood           |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 5 Deschutes      |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 18 Mid-Coast     |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | **Kelly Stokes** |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 6 John Day       |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 7 Umatilla       |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 8 Grand Ronde    |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 9 Powder         |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 10 Malheur       |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 11 Owyhee        |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 12 Malheur Lake  |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | **Rich Kilbane** |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 13 Goose &       |
|                   |   |   |     |                    | Summer Lakes     |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 14 Klamath       |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 15 Rogue         |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 16 Umpqua        |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | 17 South Coast   |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | ## Submit        |
|                   |   |   |     |                    | your completed a |
|                   |   |   |     |                    | pplication to th |
|                   |   |   |     |                    | e ODFW Regional  |
|                   |   |   |     |                    | Field Coordinato |
|                   |   |   |     |                    | r for your area. |
|                   |   |   |     |                    |                  |
|                   |   |   |     |                    | #                |
|                   |   |   |     |                    | # *Submit applic |
|                   |   |   |     |                    | ations for proje |
|                   |   |   |     |                    | cts on **federal |
|                   |   |   |     |                    |  land** directly |
|                   |   |   |     |                    |  to Jerry Van Me |
|                   |   |   |     |                    | ter, USFWS Feder |
|                   |   |   |     |                    | al Coordinator.* |
+-------------------+---+---+-----+--------------------+------------------+
| **Jerry Van       |   |   | O   | 503-231-2386       |                  |
| Meter**           |   |   | ffi |                    |                  |
|                   |   |   | ce: |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Program           |   |   | E   | jerr               |                  |
| Coordinator       |   |   | -ma | y_vanmeter@fws.gov |                  |
|                   |   |   | il: |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| U.S. Fish and     |   |   |     |                    |                  |
| Wildlife Service  |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Pacific Region -  |   |   |     |                    |                  |
| Fishery Resources |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 911 NE 11^th^     |   |   |     |                    |                  |
| Avenue            |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Portland, OR      |   |   |     |                    |                  |
| 97232             |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Ron Rhew**      |   |   | O   | 360-604-2500       |                  |
|                   |   |   | ffi |                    |                  |
|                   |   |   | ce: |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| ESA/NEPA          |   |   | E   | ron_rhew@fws.gov   |                  |
| Compliance        |   |   | -ma |                    |                  |
| Coordinator       |   |   | il: |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| U.S. Fish and     |   |   |     |                    |                  |
| Wildlife Service  |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Columbia River    |   |   |     |                    |                  |
| Fisheries Program |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 9317 Highway 99,  |   |   |     |                    |                  |
| Suite 1           |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Vancouver, WA     |   |   |     |                    |                  |
| 98665             |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
|                   |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| ## ODFW S         |   |   |     |                    |                  |
| tate Coordinators |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Ray             | O |   |     | 503-947-6215       |                  |
| Hartlerode**      | f |   |     |                    |                  |
|                   | f |   |     |                    |                  |
|                   | i |   |     |                    |                  |
|                   | c |   |     |                    |                  |
|                   | e |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Program Manager   | C |   |     | 503-705-6574       |                  |
|                   | e |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 3406 Cherry Ave   | F |   |     | 503-947-6203       |                  |
| NE.               | a |   |     |                    |                  |
|                   | x |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Salem, OR 97303   | E |   |     | Ray.E.Hart         |                  |
|                   | - |   |     | lerode@state.or.us |                  |
|                   | m |   |     |                    |                  |
|                   | a |   |     |                    |                  |
|                   | i |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Bernie          | O |   |     | 503-947-6229       |                  |
| Kepshire**        | f |   |     |                    |                  |
|                   | f |   |     |                    |                  |
|                   | i |   |     |                    |                  |
|                   | c |   |     |                    |                  |
|                   | e |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| State Fish Screen | C |   |     | 541-760-5940       |                  |
| Coordinator       | e |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 3406 Cherry Ave   | F |   |     | 503-947-6203       |                  |
| NE.               | a |   |     |                    |                  |
|                   | x |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Salem, OR 97303   | E |   |     | Bernard.M.Ke       |                  |
|                   | - |   |     | pshire@state.or.us |                  |
|                   | m |   |     |                    |                  |
|                   | a |   |     |                    |                  |
|                   | i |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Tom Stahl**     | O |   |     | 503-947-6228       |                  |
|                   | f |   |     |                    |                  |
|                   | f |   |     |                    |                  |
|                   | i |   |     |                    |                  |
|                   | c |   |     |                    |                  |
|                   | e |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| State Fish        | C |   |     | 503-703-2696       |                  |
| Passage           | e |   |     |                    |                  |
| Coordinator       | l |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 3406 Cherry Ave   | F |   |     | 503-947-6203       |                  |
| NE.               | a |   |     |                    |                  |
|                   | x |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Salem, OR 97303   | E |   |     | Thomas             |                  |
|                   | - |   |     | .Stahl@state.or.us |                  |
|                   | m |   |     |                    |                  |
|                   | a |   |     |                    |                  |
|                   | i |   |     |                    |                  |
|                   | l |   |     |                    |                  |
|                   | : |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
|                   |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| #                 |   |   |     |                    |                  |
| # ODFW Regional F |   |   |     |                    |                  |
| ield Coordinators |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Bob Hair        |   | O |     | 541-296-8026       |                  |
| (Basins 1-5 &     |   | f |     |                    |                  |
| 18)**             |   | f |     |                    |                  |
|                   |   | i |     |                    |                  |
|                   |   | c |     |                    |                  |
|                   |   | e |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| The Dalles Screen |   | C |     | 541-980-0040       |                  |
| Shop              |   | e |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 3561 Klindt Drive |   | F |     | 541-296-7889       |                  |
|                   |   | a |     |                    |                  |
|                   |   | x |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| The Dalles, OR    |   | E |     | Bob.               |                  |
| 97058             |   | - |     | R.Hair@state.or.us |                  |
|                   |   | m |     |                    |                  |
|                   |   | a |     |                    |                  |
|                   |   | i |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Rich Kilbane    |   | O |     | 541-826-8774       |                  |
| (Basins 13-17)**  |   | f |     |                    |                  |
|                   |   | f |     |                    |                  |
|                   |   | i |     |                    |                  |
|                   |   | c |     |                    |                  |
|                   |   | e |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Central Point     |   | C |     | 541-601-0810       |                  |
| Screen Shop       |   | e |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| 1495 East Gregory |   | F |     | 541-830-0365       |                  |
| Road              |   | a |     |                    |                  |
|                   |   | x |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| Central Point, OR |   | E |     | Rich.M.K           |                  |
| 97502             |   | - |     | ilbane@state.or.us |                  |
|                   |   | m |     |                    |                  |
|                   |   | a |     |                    |                  |
|                   |   | i |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| **Kelly Stokes    |   | O |     | 541-575-0561       |                  |
| (Basins 6-12)**   |   | f |     |                    |                  |
|                   |   | f |     |                    |                  |
|                   |   | i |     |                    |                  |
|                   |   | c |     |                    |                  |
|                   |   | e |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| John Day Screen   |   | C |     | 541-620-0856       |                  |
| Shop              |   | e |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| W. Hwy. 26        |   | F |     | 541-575-0868       |                  |
| Patterson Bridge  |   | a |     |                    |                  |
| Road              |   | x |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
| John Day, OR      |   | E |     | Kelly.S.           |                  |
| 97845             |   | - |     | Stokes@state.or.us |                  |
|                   |   | m |     |                    |                  |
|                   |   | a |     |                    |                  |
|                   |   | i |     |                    |                  |
|                   |   | l |     |                    |                  |
|                   |   | : |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+
|                   |   |   |     |                    |                  |
+-------------------+---+---+-----+--------------------+------------------+

![](media/image7.png){width="9.208267716535433in" height="7.0in"}

[^1]: ^^ *Related project features include modifications to associated
    water diversion structures, which are required for effective
    operation of upstream or downstream fish passage improvements or
    restoration.*