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APPENDIX A <br /> Form 1 : Application for Cost Share <br /> ( Complete a separate application for each grove/block) <br /> Owner' s Name : <br /> Business Name : <br /> Mailing Address : <br /> Street Address : <br /> Business Phone : <br /> Email Address : <br /> Grove Name : <br /> Block Number : <br /> Acreage : <br /> Check the boxes below to indicate which practices you are requesting cost-share <br /> assistance for this grove/block . <br /> ❑ IR- 1 Aquatic Weed Barrier <br /> ❑ IR-2 Chemigation Infrastructure <br /> ❑ IR- 3 Conversion to Flash Board Riser Water Control Structure <br /> ❑ IR-4 Conversion to Low Volume Irrigation System <br /> ❑ IR-5 Grade Stabilization <br /> ❑ IR-6 On-site Water Detention/Retention <br /> ❑ IRJ Permanent Agrichemical Mixing Facility <br /> ❑ IR- 8 Portable Agrichemical Mixing Station <br /> ❑ IR- 9 Precision Application Equipment <br /> ❑ IR- 10 Water Table Observation Well <br /> INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED . <br /> Revised 03/21 /02 10 <br />