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• <br /> • <br /> Eligibility includes: a public education element; AND either 1) Provides used oil curbside collection for all residents of the city <br /> including multi - family residences; or 2) Ensures that at least one certified used oil collection center is available for every <br /> 100,000 residents not served by curbside used oil collection. To establish a baseline for your program, please provide us <br /> with the following data for all participating jurisdictions: <br /> 1. Total number of certified used oil collection centers 6 <br /> 2. Total number of non-certified used oil collection centers <br /> 3. How many of these are airport collection centers? ❑ Certified .9 ❑ Non - Certified -B <br /> 4. How many of these are marina collection centers? ❑ Certified .9' ❑ Non - Certified ,q <br /> 5. Curbside used oil collection? ® Yes ❑ No What % of your population? 60 °lo <br /> 6. Door -to- door used oil collection? ❑ Yes at No What % of your population? <br /> If claiming conditional eligibility please check Yes and explain the steps to be taken to obtain eligibility during the grant term. <br /> Conditional Eligibility . ❑ Yes ❑ No <br /> Describe collection opportunities that are available within the area of jurisdiction that can provide service until community <br /> collection centers are established. <br /> • <br /> Certification: <br /> I declare, under penalty of perjury, that all information submitted to CIWMB's consideration for allocation of grant <br /> funds is true and accurate to the best of my knowledge and belief. <br /> 1 kw <br /> Signature of person authorized by resolution . Date <br /> Michael Bakaldin,_Fnvironmental Servicces Manager <br /> • Print Name and Title of signature authority <br /> Attachments: Approved Resolution and /or Authorization Letters <br /> Return form to: California Integrated Waste Management Board <br /> Attn: Mercy Caputi <br /> Grants Administration Unit <br /> 8800 Cal Center Drive, MS -14 <br /> Sacramento, CA 95826 <br /> 7 <br />